Why Baby Teeth Cavities Need Fillings

Taking Care of Baby Teeth

Every week I have moms, dads, and grandparents bring in their kids and/or grandchildren in for their regular preventive visit that consists of a checkup/exam, dental cleanings, x-rays once a year, and fluoride treatment.  As part of kids dentistry children ranging from 1 year to 4 years old, up to 12 year old, will typically have primary dentition (baby teeth) remain in their jaw.  Even some adults will have the occasional baby tooth!

When kids come in for their 6 month checkup, after the dental assistant or the dental hygienists clean their teeth to be free of plaque, I (the dentist) will check their mouth for signs of cavity, or tooth decay, via a visual exam and digital x-rays.

If I do see a cavity, depending on the size of the decay, I may recommend either leaving the tooth as a "watch" or a tooth colored filling.   However every now and then, I'll get a question from the parents or grandparents, "it's just a baby tooth, can we just not fill the cavity and leave the tooth alone?"  My usual response would be "the tooth needs a filling and we do not want the cavity to continue to get bigger."  Here's why:

WHEN DOES A CAVITY ON BABY TEETH NEED TO BE TREATED?

 A cavity can be ascertained visually and by x-rays.  If the cavity is contained within the enamel, the cavity can be left alone and treated with fluoride and proper oral hygiene (ie. daily brushing with a fluoridated tooth paste, daily flossing, and fluoride rinses).  If the cavity is small enough, proper oral hygiene and fluoride can arrest (stop the cavity from growing" and may even remineralize the cavity (ie. shrink the cavity).   This stage is when the cavity can be "watched" and left unteated.

If a cavity has progressed beyond the enamel and has extended into the dentin layer, depending on how big the cavity is, treatment is highly recommended.  If the cavity is relatively small, a tooth colored filling is recommended.  If the decay is deep enough to have hit the nerve/pulp of the tooth, a pulpotomy or "baby root canal" may be needed.  The reason a pulpotomy is needed in this case is because once decay/bacteria has reached the nerve, the nerve is at risk for infection.   Thus a baby root canal is needed to remove the nerve and decrease likelihood of infection.  After the pulpotomy is performed, a stainless crown is usually recommended to allow normal chewing.

SO WHY DOES A BABY TOOTH NEED A FILLING?

If a cavity has extended beyond the dentinal layer, a filling is required to prevent the cavity from getting larger.  Left untreated the cavity has a chance to continue to get bigger and deeper, this may cause the child to have tooth pain.   The tooth may then require a pulpotomy and stainless crown as part of emergency dentistry treatment, increasingly likelihood of inconvenience, discomfort, and financial costs.

WHY IS A BABY TOOTH NECESSARY?  CAN YOU JUST REMOVE IT?

If the cavity is deep enough that restoration is not possible or has poor long term prognosis, the baby tooth may need to be extracted.  Once remove, the space once occupied by the baby tooth may need to be held by in place by a space maintainer until the permanent tooth erupts.

And as such, a baby tooth serves the following purpose:

• Allows the child to chew properly and normally, thus permitting adequate nutrition.  Certain foods may be difficult to eat without teeth.
• Allows the child to speak normally.  Without a baby tooth in place for a sustained period of time, normal speech and certain sounds may be difficult to pronounce.
•  Holds space necessary for the adult teeth to erupt.  If a primary tooth is removed, adjacent teeth in front, back, and opposite may start to collapse into the space.  This may make it difficult for the adult tooth to coming in properly, and may cause malocclusion, prompting possible need for orthodontic treatment (braces).
• Esthetics and self confidence.  A child may feel self conscious if he or she is missing a tooth for a sustained period of time, especially the front tooth.

Though in some cases baby teeth treatment may not be necessary or possible, hopefully this article will have shed some light as to why cavities on baby teeth need treatment and why baby teeth are important to a person's health.  If you have any questions on kids dentistry, please feel to contact your dentist or dental hygienist.

Your family Bellevue dentist,
Dr. Peter Chien
425-614-1600
info@bellevuefamilydentistry.com

Dental Sealants for Kids!

Now that school is up and running again, parents may have heard their children's school nurse mention dental sealants.  So what are they?  Sealants are a protective plastic coating dentists place on posterior teeth (back teeth).  Posterior dentition, especially molars and premolars, have deep occlusal grooves, pits, and fissures.  These deep grooves are usually very fine and thin, they can be difficult to maintain proper oral hygiene.  The toothbrush's thickness is usually greater than that of the teeth's grooves, so bacteria and plaque have a high tendency to remain trapped inside the tooth.  The result is an increased likelihood of developing tooth decay.

Your dentist will first make sure the tooth's grooves are clean with a high powered flush and cleansing material.  After the tooth is properly cleaned of debris, the tooth properly dried and isolated, the sealant is flowed onto the tooth.  The sealant is then light cured and hardened, thereby protecting the grooves from potential decay (cavities).

Sealants can be a viable preventive treatment for kids and adults alike.  Dental sealants are not permanent and can wear away (ie. fall off) over time, but it's a great cost effective and simple method to help ward of cavities.

Your family dentist should be able to help you decide if dental sealants are suitable for you and your children's needs.

From your family Bellevue dentist,

Dr. Peter Chien
(425) 614-1600
info@bellevuefamilydentistry.com

Start of the school year with proper diet and oral health.

The first week of September is usually a busy one, especially with families and kids returning from vacation, and kids returning and starting a new school year.  That said, here are somethings to keep in mind:

• Did you know that some states require a child to have a dental exam as part of enrollment?  Georgia is one such state: http://www.gadoe.org/External-Affairs-and-Policy/AskDOE/Pages/New-Student-Requirements.aspx.  So be sure to check with your local school district to see if your child needs a visit to the pediatric or general dentist.
• There are multiple factors influencing your child's progress and success at school; health is one of the most important ones.  Children need to be sufficiently healthy to learn, and children with cavities and gum disease are not deemed healthy.  Tooth decay is an oral infection that may get worse without treatment and are usually preventable and very treatable
• Your child may likely need a snack during their time at school.  Try to make it fun and healthy!  Promote lots of naturally sweet fruits and crunchy vegetables instead of sugary drinks and candies.  Fruits, vegetables, and milk are great for the body, and help promote healthy and strong bone and teeth formation.  Calcium and Vitamin D in particular are great for teeth enamel and development.
• It's also a great idea to give your a child a spare toothbrush, toothpaste, and floss as part of their arsenal in their backpack.  Brushing and flossing after each meal and snack is a good way to enhance their oral health.
• School and work days can bush for everyone.  Children tend to imitate adult behavior, so if your child sees your brushing, flossing, and eating well, they should too! :)

If you have any questions regarding oral health care for your children, please don't hesitate to ask your family dentist.

From your family Bellevue dentist,
Dr. Peter Chien
(425) 614-1600
www.bellevuefamilydentist.com

National Tooth Fairy Day!

Attention parents and kids!  August 22 is the "official" National Tooth Fairy Day.  Kids, any loose baby teeth about to come out?  Parents, be on the look out :)

Most of the time baby teeth come out fairly easily.  If a tooth appears to be extremely loose and looks ready to come out, encourage your child to wiggle it.  Sometimes I even encourage a bite out of an apple, carrot, or even a sandwich to help give the tooth an extra nudge.  A little bleeding is normal when the tooth comes out; if so, firm pressure on a cotton gauze will help stop the bleeding.

I would suggest to have your kid's dentist evaluate the area if you notice:

• The baby tooth is stubborn and doesn't seem to want to come out
• The gums/gingiva around the tooth is bleeding or puffy
• The baby (primary) tooth is blocking the permanent tooth from erupting and coming into place
• Quite a few primary and permanent teeth are very close and crowded together

Crowded primary dentition is a possible predictor for orthodontic (braces) needs.  An early orthodontic evaluation can be helpful to see if braces may be needed in the future, and may even help reduce or eliminate extensive orthodontic treatment later on. 

From your family Bellevue dentist,
Dr. Peter Chien
www.bellevuefamilydentistry.com
(425) 614-1600 

Hello everyone!

As the spring season begins, I thought you might enjoy this cartoon.  Made me giggle like a little kid...

Be sure to take time out and enjoy a moment of laughter at least once a day.  Your mind and body will thank you for it :)

From your Bellevue dentist office and staff serving Bellevue, WA and Redmond, WA,

Dr. Peter Chien
www.bellevuefamilydentistry.com
(425) 614-1600

Company Will Preserve Your Child’s Baby Teeth As Stem-Cell Source « CBS Chicago

Hello everyone,

Below is an interesting link on kid's baby teeth.  Brings new light on children and dental treatment.  You should ask your dentist what he/she thinks of this possibility.  

Company Will Preserve Your Child’s Baby Teeth As Stem-Cell Source « CBS Chicago


Your family Bellevue dentist,
Dr. Peter Chien
www.bellevuefamilydentistry.com

Welcome!

Welcome to Bellevue Family Dentistry!  Please check this blog regularly for updates, news, and info about your personal family dental practice!  Periodically I will update this blog with interesting dental trivia and tidbits on topics such as teeth whitening, veneers, porcelain crowns, toothbrushes, toothpastes, and oral health.

Thank you for looking, and have a great day!


You family Bellevue dentist,
Dr. Peter Chien
www.bellevuefamilydentistry.com
(425) 614-1600