Does my child’s baby tooth need a filling?

My daughter is seven years old. One of her baby teeth has a cavity and her pediatric dentist says it needs filled. I’m struggling with this prognosis. If the tooth is going to eventually fall out, does it really need filled? Or, is the dentist just wanting the money?

Thank you,

Dear Ann,

If the tooth with the cavity on it happens to be one of your daughter’s eight front teeth, there is no reason to have it filled. However, if the tooth in question is in the back, there are several reasons to fill it, as it could be a few years before the tooth falls out since some baby teeth stay in a child’s mouth until age 12 or more. In fact, there are some adults who still have baby teeth due to no permanent teeth growing in under them. An x-ray is the only way to know this or not. Needless to say, if the tooth with the cavity is a back tooth, she needs to have it filled in order to keep the tooth and hold the space for the adult teeth to come in correctly.  Letting things go and not filling the tooth will cause further decay to build up and she will eventually have to have the tooth extracted, which can be a traumatic experience for a child. If the tooth is pulled, a space maintainer will be needed, in order to keep the space for the adult tooth. If the tooth is removed or comes out too soon, and nothing is put in its place, the other teeth takeover the space and will prevent the eruption of the permanent tooth. This would cause a definite need for orthodontics in her future. Another point to consider, if the tooth in question is her last baby tooth, is is likely it is her six-year molar. This is a permanent tooth and would most definitely require a filling.

This post was written by the office of Phoenix pediatric dentist, Dr. Hillary Peck.

Should my child be seen for a painful loose tooth?

My elementary-aged son seems to be getting ready to lose his first tooth. He recently had his dental check-up with her pediatric dentist and we were told everything appeared good and normal. However, lately he has been complaining that it feels like one of his front two teeth is getting bigger. Then, he recently bit down on a carrot and immediately started to cry. There was blood and the tooth appeared to be out of place. I thought this might all be due to the tooth preparing to fall out, but am starting to second-guess myself. Is this normal? Should I have her seen?

Thank you,

Dear Bethany,

Each tooth that is lost fights of small battle in the process which leads to it falling out. First, the permanent, adult tooth pushes the baby tooth up. This may be what is causing him to feel like his tooth is increasing in size. Next, the ligaments, which help the tooth stay in place, start to expand and strain, like small rubber bands. At times, they tighten back to their original state, white other times, they stay stretched and snap. It is quite possible the tooth was in fact loose and the ligaments were already stretched. Then, when he bit into the carrot, the bite forced the tooth out of alignment and caused some of the ligaments to snap. In this situation, popsicles are great, as well as avoiding hard foods. The tissue around the tooth was likely traumatized, but it’s unlikely any long-term issues or serious damage were caused to the adult tooth coming in. If your son is not in any pain now, and the area seems to be healing on its own, it’s not crucial that he be seen. However, if you are not certain, or will feel better doing so, seeing a pediatric dentist would be a good idea. In a rare situation, additional damage could be causes, which could require dental intervention. But, it sounds like stocking up on soft foods and popsicles is a good idea…and prepare for a visit from the Tooth Fairy!

This post is sponsored by the office of Phoenix pediatric dentist, Dr. Hillary Peck.