Has your child ever had toothache because of a badly decayed baby tooth?
If the baby tooth could be saved, would you choose to save it, or pull it out (extraction)?
Most people believe that if a baby/milk tooth is badly decayed, the dentist can just remove the tooth (even if it can be saved) because the adult tooth will grow and replace it later. Another reason is because the alternative – which is saving it, can be costly as it involves removing the nerve and blood vessels of the tooth (pulpotomy or pulpectomy). BUT, don’t give your dentist the green light to pull out the tooth just yet! Because despite that, it is recommended that if a baby tooth can be saved, SAVE it! Especially if your child is still very young.
Why save the baby tooth?
There may be negative effects if the tooth is pulled out too early before the adult tooth can come out. Below are some of the reasons:
1. Low self-esteem
Studies have shown that children who have their teeth taken out may have lower self-esteem., This can affect their quality of life and wellbeing [1]. Not only that, they may also be subject to bullying and teasing by their peers in school due to their missing teeth [2].
2. Difficulty speaking and eating
Children who lose multiple teeth at a young age can have difficulty in chewing, which could lead to undetected malnutrition. Also, if they have their upper front teeth taken out, they may have trouble speaking properly. They may experience distortion when pronouncing ‘f’, ‘th’, ‘z’ and ‘s’ [3].
3. Teeth crowding and malocclusion
Let’s imagine your child is now 6 years old and has a bad decay in one of his baby teeth, and the tooth is extracted. What will happen? Let’s say that the particular adult tooth is only going to come out to fill the gap at about 10 years old. That’s 4 years of waiting! But now there is a gap, and the teeth behind that gap won’t sit still, they will move forward slowly but surely over the years. Then by the time he is 10, there will be a lack of space for the adult tooth to come out properly. That is when the tooth is forced to grow in an unfavourable position and crowding occurs!
The child may also develop a poor bite (malocclusion). In these cases, the child will more likely need braces in the future [4].
4. Increases child’s dental fear
Pulling out a tooth is no fun, even for adults! Studies have shown that children are most afraid of injections and tooth extraction. Hence if a child has to undergo an extraction, he may become very anxious or scared and this could turn into a traumatizing experience. He won’t want to return to the dental clinic in the future, and this fear can carry on into adulthood [5]!
What if you cannot afford other treatments?
All that being said, what if you are unable to afford other treatments to save the baby tooth? Well, here are some ways for you to prevent that situation – which is to prevent tooth decay from happening to your children in the first place!
1. Proper tooth brushing
Tooth brushing is essential. Brushing should start when the first baby tooth erupts. It is recommended that you should monitor your children when they are brushing until they reach 6 years old, even if they can brush on their own. The simplest way to do this is to brush together with them. They should brush using fluoridated toothpaste twice a day and should not eat any food after brushing [7]. However, make sure that they do not swallow the toothpaste! Read more about the effects of swallowing toothpaste for children here.
2. Regular dental visits
It is recommended to bring your child to see the dentist every 6 months [7]. When you bring your child to see the dentist regularly, the dentist would be able to pick up any problem before it worsens into the situation that needs more expensive treatment. This will definitely cost you less in the long run. For Malaysians, you may visit any government dental clinic which offers very affordable treatments!
3. Reduce snacks and sweets
Sugary snacks and sweets or confectionaries that are eaten between mealtimes creates a favourable environment for bacteria to attack the teeth. This will cause a higher chance of tooth decay. It is best to reduce snacks and sweets, or if needed, only eat them together with meals [8].
When NOT to save the baby tooth?
Unfortunately, there are some situations when you have to pull out the baby tooth. For example, if your child has a toothache and the adult tooth is coming out soon, the dentist will recommend to relieve your child’s pain by pulling out the tooth. This is because there is only a short amount of time before the adult tooth comes out.
Another case is if the tooth is very badly decayed or if the tooth has become very loose due to trauma, and even alternative treatment cannot save it. In this case, if the adult tooth is not due to come out for another few years, the dentist may suggest a space maintainer or prosthesis after pulling out the baby tooth.
Conclusion
In short, make sure to consult your dentist! If your dentist recommends saving the baby tooth, try to save it! This is to prevent the negative consequences of pulling out the tooth early. However, if the tooth is very badly decayed, or if the adult tooth is coming out soon, then the baby tooth can be pulled out. Alternatively, you can prevent getting caught in this dilemma – by taking care of your child’s teeth from a young age with proper brushing and non-surgary diet, and also regular dental check-ups! Your children will thank you in the future.
References
- Kaur P, Singh S, Mathur A, Makkar DK, Aggarwal VP, Batra M, Sharma A, Goyal N. Impact of dental disorders and its influence on self esteem levels among adolescents. Journal of clinical and diagnostic research: JCDR. 2017 Apr;11(4):ZC05.
- Al-Omari IK, Al-Bitar ZB, Sonbol HN, Al-Ahmad HT, Cunningham SJ, Al-Omiri M. Impact of bullying due to dentofacial features on oral health–related quality of life. American Journal of Orthodontics and Dentofacial Orthopedics. 2014 Dec 1;146(6):734-9. (Link)
- Nadelman P, Bedran N, Magno MB, Masterson D, de Castro AC, Maia LC. Premature loss of primary anterior teeth and its consequences to primary dental arch and speech pattern: A systematic review and meta‐analysis. International journal of paediatric dentistry. 2020 Nov;30(6):687-712.
- Martins-Júnior PA, Ramos-Jorge ML, de Paiva SM, Pereira LJ, Marques LS. Premature deciduous tooth loss and orthodontic treatment need: a 6-year prospective study. Journal of Public Health. 2017 Apr 1;25(2):173-9.
- Alsarheed M. Children’s perception of their dentists. European journal of dentistry. 2011 Apr;5(2):186. (Link)
- Public Health England. Delivering better oral health: an evidence-based toolkit for prevention. 12 June 2014.
- American Academy of Pediatric Dentistry. Periodicity of examination, preventive dental services, anticipatory guidance/counseling, and oral treatment for infants, children and adolescents. The Manual of Pediatric Dentistry. Chicago: AAPD. 2018:209-19.
- Skafida V, Chambers S. Positive association between sugar consumption and dental decay prevalence independent of oral hygiene in pre-school children: a longitudinal prospective study. Journal of Public Health. 2018 Sep 1;40(3):e275-83.
