Primary teeth, commonly known as baby teeth, are the first set of teeth that develop in a child’s mouth. Although temporary, cavities are a frequent concern for parents and require professional attention. Tooth decay is a progressive disease that demands timely intervention from a pediatric dentist for pain relief, infection control, and proper oral development.
Why Baby Teeth Cavities Need Treatment
A common belief is that treating decay in temporary teeth is unnecessary, but this overlooks the significant roles primary teeth serve. These teeth act as placeholders, maintaining the correct spacing required for permanent teeth to erupt into their proper positions. Losing a baby tooth too early due to untreated decay can cause neighboring teeth to shift, potentially leading to crowding or misalignment issues for the adult teeth.
Primary teeth are also fundamental for daily functions, including proper chewing and the ability to speak clearly. Untreated decay causes persistent pain and sensitivity, leading to difficulty eating and potential nutritional deficiencies. The risk of infection spreading deep into the tooth is concerning, often forming an abscess. This abscess can damage the developing permanent tooth underneath or, in severe cases, spread to other parts of the body.
Specific Treatment Methods for Pediatric Cavities
Treatment methods vary depending on the depth and extent of the decay found in the tooth. For early or mild surface decay, non-invasive approaches are often the first line of defense to stop the progression. Silver Diamine Fluoride (SDF) is a topical liquid applied directly to the decayed area. The silver component kills bacteria, and the fluoride promotes remineralization, though a notable side effect is the permanent black staining of the treated lesion.
Fluoride varnish is another non-invasive measure, a highly concentrated substance painted onto the tooth surface that strengthens the enamel through remineralization. This professional application is quick and is often recommended every three to six months for children at high risk for new cavities. When decay has progressed beyond the surface enamel and into the underlying dentin, a traditional restorative material is required. Fillings involve removing the decayed structure with a drill before restoring the tooth’s shape.
Composite resin fillings are tooth-colored, making them aesthetically pleasing, and they bond directly to the tooth structure. Amalgam fillings, made from a mixture of metals, are known for their superior durability. They are often chosen for large cavities in back molar teeth that endure heavy chewing forces. For moderate to advanced decay that has reached the soft inner pulp chamber, a more extensive procedure known as a pulpotomy may be necessary.
A pulpotomy, sometimes called a “baby root canal,” involves removing only the infected pulp tissue located in the crown of the tooth, leaving the healthy pulp in the roots intact. Once this nerve treatment is complete, the tooth is structurally compromised and requires a full-coverage restoration. Stainless steel crowns (SSCs) are pre-formed metal caps fitted over the entire tooth to seal and protect it until it naturally exfoliates. SSCs are durable and can often be placed in a single visit, which is advantageous for young patients.
In cases of severe infection or extensive decay that cannot be restored, extraction of the baby tooth becomes the last resort. If a tooth is removed prematurely, a space maintainer—a fixed or removable dental appliance—is placed to hold the gap open, preventing the remaining teeth from shifting and preserving space for the permanent tooth.
Maintaining Oral Health After Treatment
Post-treatment care focuses on preventing new decay through consistent home hygiene and professional preventative measures. Brushing twice daily with fluoride toothpaste is fundamental, requiring parents to supervise this routine until a child is seven or eight years old. For children under three, the correct amount of toothpaste is a smear the size of a grain of rice. This increases to a pea-sized amount for those aged three to six and older.
Dietary modifications play a large role in limiting the fuel source for decay-causing bacteria. Parents should limit the frequency of sugary and acidic drinks, encouraging water and dairy products instead. Foods like cheese, crunchy fruits, and vegetables help promote saliva production, which naturally cleanses the mouth and neutralizes acids.
Regular professional checkups allow the dentist to monitor treated teeth and apply preventative measures. Dental sealants, thin protective coatings, are painted onto the chewing surfaces of back molars to fill in deep grooves where food and bacteria accumulate. Applying sealants shortly after the permanent molars erupt is effective at reducing the risk of decay in these vulnerable areas.