After informing a parent their child has a cavity, the most common question I am asked is: “Do baby teeth need fillings? Can’t we wait til the tooth falls out?’
The answer is not always simple. As pediatric dentists we look at key factors to answering the questions.
Three Factors Influencing if Baby Teeth Need Fillings
- How close the tooth is to falling out
- Calculating the size of the cavity
- Assessing your child’s cavity-risk.
How Close is the Baby Tooth To Falling Out?
If the tooth is going to fall out soon we may recommend just improving oral hygiene with brushing and flossing as well as coming to regular check-ups with your pediatric dentist. This will typically be recommended if the baby tooth is loose or is projected to get loose within the next 6-12 months.
We assess this by seeing how much of the baby tooth root is still present. As the adult tooth prepares to come in, it will dissolve the baby tooth root more and more over time. X-rays are necessary to answer this question.
Calculating the size of the cavity
Most cavities we see on the X-ray or on our clinical exam have reached the inside layer of the tooth called dentin. Dentin is softer and more porous than the outer white layer called enamel. When the cavity is in that inner layer, it can spread fast. At that point we recommend filling the tooth with a white filling.
If the cavity is bigger and on multiple surfaces of the tooth we may recommend the tooth be restored with a crown. If the cavity is so big that a filling or crown wouldn’t fix the tooth properly, your pediatric dentist will recommend extraction.
Sometime the tooth only has a tiny “Pre-cavity spot”. Pre-cavity spots are areas of demineralization where the cavity- causing sugar bugs are just starting to invade and infect tooth. They have barely scratched the surface of the outer enamel layer of the tooth. In these cases, pediatric dentists will monitor these areas to see if they get bigger. They will recommend you improve oral hygiene and maybe even increase the number of times a day you clean your teeth.
Assessing your child’s cavity risk
Cavities are infections and may recommend fixing cavities on baby teeth if it is a significant infection. Cavities can pass from tooth to tooth, just like a cold. So, if you leave a cavity in a tooth long enough, your child’s other teeth can start to get cavities. The cavity causing sugar bugs multiply and they swim around in the same environment – your mouth!
Have the Cavity Evaluated
In short, if you have a high risk of getting even more cavities, your pediatric dentist may recommend fixing the tooth so your other teeth are protected.
As you can see, there are many factors in deciding whether a tooth needs to be fixed.
You can trust our board certified pediatric dentists, Dr Dylan Bordonaro and Dr. T Jay Robinson to let you know when a baby tooth need to be filled.
If you think your child may have cavities, please call our office at 303-455-3313 for an appointment.
