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Why Fix a Baby Tooth or Child's Molar

By Jane A. Soxman, DDS

Parents are often surprised to learn that their children have dental decay. They question the need to repair or restore the baby teeth because, after all, they are going to fall out. The following information will help you to understand the need to obtain a dental examination by a pediatric dentist and pediatric dentistry team for your little one no later than two years of age and why restoring his or her baby teeth is so very important.

  • Twenty primary (baby) teeth and baby molars are usually present by three years of age. Before the teeth erupt into the mouth, the bacteria that cause tooth decay are swallowed with food or saliva. The cells on the inside of the mouth are shed and constantly replaced. When the first tooth appears, usually around five to six months of age, there is now a surface for bacteria to adhere to and multiply. Your baby's mouth should be wiped clean after every feeding. The bacteria that cause tooth decay (dental caries) will use the food residue to form lactic acid that will eventually break down the enamel of the teeth. The enamel on primary teeth is very thin compared to the permanent teeth. Once it begins, decay will progress rapidly. Constant exposure to sugary liquids in baby bottles or sippie cups will also result in tooth decay. The first sign may be a white spot (demineralization) or tiny hole in the surface of the enamel. Children will not necessarily complain of a toothache even with a large cavity. As you are cleaning the teeth, look for any signs of a dark spot or hole on each tooth. See your pediatric dentist as soon as possible. Many parents delay this first visit to the pediatric dentist because they believe the child will not cooperate for treatment. Tooth decay is not like a cold. It will not go away without pediatric dentistry treatment. If decay is caught early, the procedure to restore or repair the tooth may be quite simple, but delay may require more extensive treatment or even an extraction. Your pediatric dentist will guide you and your child carefully through the procedure.
  • The primary teeth must be present to help guide the proper path for eruption (coming into the mouth) of the permanent teeth. The eight baby molars are usually lost between 9 and 13 years of age. If a baby molar is lost too early because of decay, the permanent molar that erupts at six years of age will have no guide for its proper position. It will move forward in the jaw and block out the space for the permanent tooth that was to later replace the baby molar.
  • If a child has a toothache or pain with chewing, he will not be able to eat properly. Decayed molars may affect a child's nutrition and could result in weight loss.
  • Before two and a half, the upper front primary teeth (incisors) are necessary for normal speech development. The facial appearance will also be affected by the early loss of the incisors. An appliance with denture teeth can be made to replace these teeth if necessary. Your child's age and ability to cooperate will determine whether or not this appliance can be offered by your pediatric dentist.
  • Abscess of the tooth may occur if tooth decay is not treated. A bubble may form on the gum near the abscessed tooth. Pus may drain from the bubble if gentle pressure is applied. Fever, pain, and any facial swelling require immediate attention and treatment. Children who have diabetes, heart defects, or who are under medical care for other conditions should also be seen by a pediatric dentist without delay when dental problems arise. In some cases, an untreated abscess could result in a hospitalization.
  • The baby molars develop deep in the bone between the roots of the primary molars. Extensive decay of a primary molar may require an extraction (removal). Extraction of a primary molar in a toddler or pre-schooler could cause the accidental removal of the developing permanent tooth.
  • Decay can spread from one tooth to the other by direct contact or by shedding into the saliva. Children who experience decay in the primary teeth are more likely to have decay in the permanent teeth. Removing the decay and restoring the primary teeth will help to decrease the number of decay-causing bacteria in the mouth. The permanent teeth will have had the advantage of fluoride to strengthen the enamel and by decreasing the number of decay-causing bacteria, you can make sure you child's permanent teeth have healthy start!
  • The quality of your child's life may be affected by extensive decay. Growth and weight gain, school performance, behavior, and sleep patterns may be influenced.

What Can You Do?

Brush your child's teeth until he or she is six years of age. Bedtime brushing is especially important. Floss the teeth if there are no spaces between them. Use a fluoride mouth rinse after six years of age if decay is occurring. Avoid constant snacking with crackers, chips, or soft drinks. Nothing but water should be in a baby bottle other than meal time. Restrict juices except at mealtime.

Your child should be examined by his or her pediatric dentist every six months. Do not delay treatment because you believe he or she cannot cooperate or may be fearful. As in your child's medical care, prevention is so very important. Your knowledge and efforts toward good dental care will influence your child's oral health for the rest of his or her life. Let's work together to keep that beautiful little smile a healthy one!