When facing the decision to invest in restoring decayed primary teeth, I am often asked the legitimate question by parents. “Why should we put money into the baby teeth? Aren’t they just going to come out anyway?”

Primary teeth are smaller and less durable than permanent teeth which have much thicker enamel and larger roots. This second set is designed to last a lifetime, the first is not. So why bother repairing them when they get decayed? Why not just leave them alone or take them out? Here are my top three reasons:

  1. Primary teeth can get badly infected due to untreated decay and cause an abscess in the jaw. This can be very painful for the child and damage the permanent tooth that is forming in the bone.
  2. The jaw grows from the back not the front. Once the 1st permanent molars come in at age 6, the distance around the arch from molar to molar is established and will not grow on its own. If primary teeth lose their size due to decay, or are prematurely removed, the permanent molars will drift forward reducing the arch size. This space can only be regained through orthodontic treatment.
  3. Dental decay is an infection. If cavities in primary teeth are not treated, the permanent teeth that erupt into this infected environment are more likely to decay themselves.

Having said this, there are exceptions to treating all decay in primary teeth.
-If the primary tooth will be gone within 6 months and the decay is in the very early stages, I often do not treat it.
-If the primary tooth will be gone within 6 months and the decay is very severe, I will remove the tooth early.

Taking proper care of primary teeth is essential to the health of permanent teeth designed to last a lifetime. So follow the recommendations of your dentist and dental hygienist in order to give your child the best chance of having a cavity free mouth.

This will be my last column in the Clackamas Review. If you have found value in the information I have shared, you can continue to read articles I will write through our Facebook account at www.facebook.com/staffordsmiles.

Yours for excellent dental health,
Dr S