To Pull or Fill, That is The Question

Every parent wants their child to have perfectly healthy teeth, so it can be disconcerting for parents when their baby has dental decay. Because baby teeth eventually do fall out to make room for adult teeth, the question of filling a cavity in baby teeth versus pulling the teeth is of valid concern. In most cases, though, filling a baby tooth is preferred.

Why are Baby Teeth Important?

Baby teeth erupt and come through the gums from the age of about six months to two years old. These baby molars don’t come out until age 10-12, so they are with your child for a long period of time and it is important to take care of them.

These teeth are called primary teeth and serve many crucial functions such as chewing, speech, esthetics, and holding space for the permanent teeth. 

As babies grow, they need their teeth to chew food properly. Teeth help to break down the pieces of food so the enzymes in saliva can further break down the food molecules for proper digestion and absorption. Teeth are essential in beginning the complex process of providing adequate nutrition for the growing child.

Baby teeth are also important for speaking, jaw formation, and facial appearance.  Missing teeth can affect speech patterns and cause a speech impediment. Because teeth also affect how jaw formation and facial appearance, missing teeth can lead to orthodontic issues. In addition, a child’s self-esteem can be negatively affected.

Maintaining space for the adult teeth is also the job of the baby teeth.  Adult teeth often form beneath the baby teeth and erupt through the gums in the same position. When a baby tooth is missing, the space can collapse, the permanent tooth is blocked, and thus crowding occurs.

Consequences of Improper Oral Hygiene and Cavities 

Babies, toddlers, and young children may need help with oral hygiene. Without proper brushing and flossing, the resulting plaque can increase the likelihood of cavity development.

Besides the issues mentioned above, cavities in baby teeth can be painful, leading to discomfort and sleeplessness for infants and children. Because the enamel is thinner in baby teeth, cavities progress faster than in permanent teeth. Therefore, parents must respond quickly to fight total tooth breakdown.

Baby teeth have nerves just like permanent teeth. If decay reaches the nerve, severe toothaches and ultimately abscessed teeth can develop.  Many school days are lost nationwide due to pain and infection from decayed baby teeth. 

Are There Times When Baby Teeth Should Be Pulled?

There are times; however, when it may be necessary to pull a baby tooth. A question to consider is whether the permanent tooth underneath is near to eruption. If yes, pulling the baby tooth may not be such a bad decision. Sometimes teeth need to be pulled to help guide the permanent tooth into position. If a permanent tooth is far from breaking through the gums, removing the baby tooth is not recommended. However, if a baby tooth is non-restorable or infected due to excessive decay, extraction may be the better option.

Facts About Cavities in Primary Teeth

A recent article by Colgate cites several facts about childhood cavities:

• According to the World Health Organization, cavities affect 60% to 90% of school-age children.

• The Herman Ostrow School of Dentistry of USC states that poor oral health in children can lead to lower grades and missed school. 

• Although preventable, early childhood tooth decay is one of the most common diseases affecting children worldwide, according to a study in Frontiers in Pediatrics.

For these reasons and many more, the oral health of your child should not be taken lightly. If you are unsure about whether your child has a cavity in their baby teeth, be sure to consult with pediatric dentist Dr. Joby Hurst for his diagnosis and recommendations.