Do baby teeth need to be filled?

“Aren’t they going to fall out anyways?”  It is true baby teeth fall out, starting around the age of 6 and continuing until around the age of 11 or 12.   As you can see, some baby teeth we maintain for quite some time.  Their importance is for chewing, jaw development, and space maintenance for permanent teeth to have room to erupt.  If a cavity is left untreated in a baby tooth, the bacteria can cause an infection, even severe enough to damage the permanent tooth developing underneath (this is called Turner’s tooth.)  The cavity is home to destructive bacteria, that can harm surrounding teeth.   If the baby tooth is lost prematurely due to decay, we need to be certain to maintain space for the permanent tooth. 

When I see decay on a baby tooth I look at a few things:  

 How much longer do I expect this tooth to be in function?  How large is the cavity? 

  If the tooth is nearing exfoliation, (when the roots are resorbed enough for the tooth to fall out) we don’t always have to do a filling.  If the cavity is very small, it can be left alone and allow the tooth to fall out untreated,  or treated with Silver Diamine Fluoride (SDF)  If the cavity is very large I may recommend removal of the tooth.  As a reminder, this blog is written for information only, and can not be used to diagnose— please consult with your dentist.

If the tooth needs to be in function for more than a year I recommend treatment. Usually this is a composite filling, however deeper cavities may need pulp treatment “baby root canal” and a prefabricated crown- stainless steel or zirconia (white.)   If the tooth needs to be in function for more than a year but the cavity is too large (too infected) to restore, I recommend removing and when necessary placing a space maintainer - similar to a small wire retainer- that will help hold the space for the adult tooth. 

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