Baby Tooth Decay - Fix Or Pull?

We don't usually think of baby tooth decay as a major problem, since by far and away most cavities don't occur until adulthood. But when those tiny little teeth in a child's mouth start showing signs of a cavity, it raises a question: Fix the tooth, remove the tooth, or let the tooth fall out naturally?

Letting the tooth fall out naturally is the least favorable option and should not even be considered. Cavities are hotbeds of infection and bacteria, which can enter the bloodstream under the tooth, leading to illness. In addition, before the tooth becomes decayed enough to fall out, the child may be experiencing tooth pain, which can cause problems with chewing, leading to nutrition issues. Lastly, late-stage decay can cause cosmetic issues, and even bad breath. With all that being said, if the tooth is about to fall out naturally due to an adult tooth erupting, the dentist may elect to let the tooth fall out naturally, but only if the baby tooth is within a few months of coming out.

Since the option of letting the baby tooth decay further is not a good one, the question still remains: fix or pull?

As with any question about your child's teeth, you should consult with a dentist (or two) about options for treating baby tooth decay.

Dentists will sometimes fix the baby tooth, and other times pull, depending on a variety of factors. These factors include the degree of infection, the progression of the underlying adult tooth, and others. Removal can be done and a spacer may optionally be used to keep the space for the future adult tooth. Ask the dentist if removing the tooth will possibly cause crowding in the adult teeth.

The importance of baby teeth to keeping proper spacing is written about in "Your Child's Teeth" ( If the baby tooth is pulled too early, the adult teeth may come in too close together, causing crowding, crookedness, and the need for braces.

Your child's dentist should help guide you as to the best path to take. However, in the event the dentist elects to pull the tooth, be sure to ask about "spacers". These devices fit between the remaining baby teeth and can prevent crowding in the adult teeth.

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