Five St. Louis area dentists recently answered questions regarding children’s oral health care. In last week’s issue, you read what dentists had to say about when children should begin dental visits and a description of typical oral health services for youngsters.
In the second of a three-part report, they talk about procedures other than the standard cleanings and checkups, and how proper care of baby teeth can lead to adult teeth that can last a lifetime.
Participating dentists are Karen Richardson, DDS of Betty Jean Kerr People’s Health Centers; Duane Dilworth, DDS of St. Louis County Department of Public Health; Candace Wakefield, DDS of Children’s Dental Zone!; Kelli Dorsey, DDS of Affinia Healthcare; and Kim Butler Perry, DDS of A.T. Still University and Affinia Healthcare.
Q: When is it considered safe for children to undergo more invasive procedures, such as fillings, extractions, etc.?
Richardson: Dental caries [cavities] are a treatable disease that should be addressed as soon as it is detected. Children ages 1 and older can undergo invasive dental procedures. The earlier the disease is detected and treated, the less invasive are the dental procedures. Generally, dental treatment is very safe however, there can be associated risks and complications.
Dilworth: Children should have fillings, extractions and dental treatment as needed regardless of age.
Wakefield: It is completely safe for children of all ages to have their teeth that have been affected with decay treated by appropriate dental procedures. As pediatric dentists, we treat children hourly that unfortunately require dental restorations as a result of dental decay. It is however, unsafe to avoid dental treatment, allowing bacteria from the dental infection to ensue to the point that the child experiences pain, has difficult eating and facial swelling, that could develop a life-threatening abscess.
Dorsey: A child as young as 1 – 3 years may need fillings or extractions if the tooth has a cavity that is deep enough to cause an abscess or decayed to the point where the tooth cannot be restored.
Butler Perry: Routine brushing, flossing and regular dental visits is our first
goal. In the event cavities are found by the dentist, it is important that they are addressed immediately. The dentist may recommend a filling, a baby root canal or he or she may say that the cavity is too bad, and the tooth cannot be saved. Usually, at that time, an extraction is indicated. Delay in seeking care can cause the cavities to get worse and possibly lead to infections. Seeking a dentist who has experience treating children in need of more complex procedures is the first step. Seeking appropriate timely care is critical for children as infections can develop and spread quickly in children compared to adults. In rare instances, we have had children to
die from infections that have developed from untreated cavities. While prevention is the key, when decay and infections are found, they should be treated immediately.
Is it necessary to fill baby teeth that are going to fall out in a few years?
Richardson: Yes. Baby teeth are important for speech and facial development and also to maintain space for the proper eruption of the permanent teeth. Premature tooth loss may lead to lack of confidence and malalignment of the permanent teeth that may require orthodontic treatment (braces). Our ability to chew and eat healthy foods allows the necessary nutrients that are needed for growth and development. Bacterial infections that can result from tooth decay can have dire consequences for children resulting in medical complications that can be life-threatening if not treated.
Dilworth: Yes, It is necessary to fill baby teeth. Primary teeth serve the same function as adult teeth. A child does not have a permanent dentition until nine or 10 years of age. Primary teeth can have cavities, toothaches, and become infected just like adult teeth. A primary tooth holds the space available for a permanent tooth; therefore, early loss of primary teeth can lead to the need for orthodontic treatment later.
Wakefield: Of course it is! Children need their teeth to be in good condition in order to chew their food effectively and speak correctly. The earliest baby teeth are shed/lost between the ages 6-8 years old. Those teeth include the maxillary and mandibular incisors. The remaining 12 baby teeth (back teeth) are generally lost between the ages of 10-12. If a 3-year-old child presents with cavities on a “back tooth” that is left untreated until age 10, that’s essentially seven years! First of all, a tooth that has decay when a child is 3 will not survive for seven years! Eventually, the decay process will spread and destroy the dental tissues, including the nerve and surrounding gum and bone area, resulting in the need for a dental extraction. So, will he teeth “fall out?” Eventually, but if left to decay without intervention, they will require extractions and will still require treatment before they were naturally intended to be shed.
Dorsey: It is necessary. An infected baby tooth can be just as damaging as an adult tooth. Infection can spread to cause facial swelling, which can then lead to more extensive surgeries in the future. That’s one of the reasons why we encourage people to start getting exams early and at least yearly, so you can address any pathologies before they become severe.
Butler Perry: Yes, Primary, or “baby,” teeth are important for many reasons. Not only do they help children speak clearly and chew naturally, they also aid in forming a path that permanent teeth can follow when they are ready to erupt. Again, seeking appropriate timely care is critical for children as infections can develop and spread quickly in children compared to adults. Studies have shown that children with untreated dental caries, miss over millions of hours of school collectively, they have difficulty, learning, often fall behind in school and suffer from poor nutrition. In rare instances, we have had children to die from infections that have developed from untreated cavities.
In the next issue, the dentists wrap up with advice on what parents can do at home to keep children’s teeth healthy and strong.
