Every child’s smile affects their sense of self esteem and confidence in life. Primary teeth are important because they help guide proper eruption of the permanent teeth. Primary teeth help maintain good nutrition with proper chewing. Primary teeth help with the development of speech. Untreated baby teeth can affect the development of the permanent teeth. Not treating the teeth can result in a patient with severe pain and possibly developing an abscess
An Abscess “Is a collection of pus that has accumulated in a cavity formed within a tissue because of an inflammatory process in response to either an infection process, usually caused by bacteria.” (Wikipedia) An abscess can be very dangerous and lead to swelling and severe pain.
Many times we encounter the dilemma, what do we do with baby teeth that have severe decay? Parents are often surprised when they learn that their child has dental decay, “they are baby teeth, can you just pull them?” They question the need to restore primary teeth.
Let’s start by saying that primary teeth or baby teeth serve a very important purpose; to save the space for the permanent teeth. The twenty primary teeth are replaced by twenty permanent teeth. If a baby tooth is lost before the permanent tooth is ready to erupt, adjacent teeth will drift and tip into the empty space. This will cause serious space problems when the permanent tooth is ready to come into the space that is been lost.
The primary teeth must be present to help guide the proper path for eruption of the permanent teeth. The anterior teeth are lost naturally between 5-6 years of age. The eight baby molars aren’t ready to come out until 9-13 years of age. If a primary second molar is lost too early because decay, the permanent molar that erupts at six years of age will have no guide to its proper position. It will drift forward taking the space of the adjacent unerupted permanent tooth and blocking it out.
If a baby tooth has decay your dentist will recommend fillings to prevent spreading of the decay. If the decay is too advanced and the tooth cannot be restored with a filling, the doctor may recommend a stainless steel crown or silver cap. The stainless steel crown provides the tooth with full coverage that is long lasting, until the permanent tooth is ready to erupt.
When the decay travels to the center of the tooth where the nerve and blood vessel lie, a pulpotomy can be performed to remove the decay and nerve. If the infection spreads to the bone and causes an abscess, the tooth will need to be extracted. Soon after the extraction a space maintainer should be fabricated to fit the space. The space maintainer is an appliance that is custom fit to the patient’s mouth and stays in the child’s mouth until the permanent tooth starts to erupt. The appliance itself will prevent the adjacent teeth from drifting or tipping into the space.
Dr. James L. Johnson