Should Decayed Milk Teeth Be Saved Or Extracted?

Should decayed milk teeth be saved or extracted?" is one of the most common questions that dentists get asked in their practice.

Milk teeth, also called primary teeth or deciduous teeth, are replaced by permanent ones by the time children enter their teenage years. This sometimes leads parents to believe that they don’t have to worry too much if one or two primary teeth do need to be removed and thus ignore caries.

The direct co-relation of a child not having many of their teeth or having a large number decayed teeth is that they are unable to eat and drink properly and thus compromise the nutrition they are getting. This will have a direct impact on their growth and development, possibly leading to much more serious and long-lasting damage down the line.

There are a couple of other reasons as well why parents and even dentists sometimes disregard the health of the milk teeth.

Children Are The Most Difficult Patients

Taking young children to any doctor can be challenging, but the dentist provides a whole different level of difficulty to parents. Getting your child to accept dental treatment is probably the only kind of treatment where the co-operation of the child is necessary to carry out the treatment. Simply put, if the child refuses to open his/her mouth, then there is very little that the dentist can do about it.

Parents also worry that the treatment is going to cause a lot of pain to the child and they thus perpetuate the myth about dental treatment being unbearably painful. As a result, when the children finally make it into the dental clinic, the level of apprehension and fear in their minds is so high that they are unwilling to listen to reason most times.

Saving Teeth Is Expensive And Time Consuming

Extracting a tooth may be a little scary to patients, but at least they know it's final. On the other hand, trying to save a tooth through root canal treatment means coming back to the dentist multiple times, facing the child’s tantrums more than once and finally paying much more.

In a lot of countries around the world, dental treatment is still considered to be very expensive and is not a priority. Parents feel that having a decayed milk tooth extracted is just simpler and cheaper.

The answer to the question about saving or extracting a milk tooth should be taken with a number of considerations in mind. In general, though, the dentist and the parents should try and save a tooth if it can be saved. There are a few exceptions to this rule and we will deal with those later.

Here are some reasons why milk teeth are very important for children.

Milk Teeth Guide The Permanent Teeth To Their Proper Position

The number of deciduous teeth in the mouth will total 20 and they will help guide 28 permanent teeth into their proper positions in the mouth. (We have excluded the 4 wisdom teeth since they are no longer considered to be essential to the dentition).

Treatment Of Decayed Milk Teeth

How do the milk teeth guide permanent teeth to their positions? The developing permanent teeth are in close proximity to the roots of the milk teeth. In fact, the roots of the milk teeth start to get destroyed from pressure exerted by the permanent teeth and eventually become loose and fall out.

Now, here is the caveat that parents need to remember. There is no certainty that the permanent teeth will erupt in their right position if all the deciduous teeth remain in place, nor is there any guarantee that the permanent teeth will erupt in malpositions if the deciduous teeth are extracted early.

Both the scenarios are demonstrably more likely to occur, however.

Milk Teeth Save Space Inside The Jaws For The Permanent Teeth

The crowns or the part of the teeth that are visible inside the mouth are responsible for maintaining enough space for the permanent teeth to come out. All our teeth, primary or permanent, have a tendency to shift into empty spaces. Thus, space for the permanent teeth can be lost if the primary teeth are extracted too early.

This is also the same reason why decayed primary teeth should be restored and covered with crowns if necessary.

There Are Plenty Of Options To Save The Milk Teeth

As with any other medical procedure, constant supervision, regular checkups, and early intervention will help save time, money and discomfort to the patient. In the case of decayed milk teeth, this means getting cavities filled at the earliest possible time before there is a need for root canal treatment to be performed.

The milk teeth are smaller in size and thus the decay can get to the nerve endings at the center of the teeth much faster. Even a seemingly small amount of decay may need a root canal procedure.

If your child has suffered from tooth decay in the past, then consider getting a pit and fissure sealant procedure or a tooth fluoridation program to try and reduce the possibility of further decay happening.

A Few Situations Where Extraction Of Milk Teeth Is Okay

There are a few situations where the dentist might consider extracting the milk teeth. The first is when the successor permanent tooth is about to erupt and so removing the milk tooth will not make a difference.

The other is when the milk tooth is still in the mouth even though the successor permanent tooth has erupted in the mouth. Such a milk tooth is called an over-retained deciduous tooth and it can wreak havoc on the dentition.

Another situation where dentists might remove the milk tooth ahead of time is when the patient in question is unable to afford or unwilling to undergo any other treatment. Such decisions have to made in developing nations where other treatment options are just inaccessible. Eventually, the doctor may decide to relieve the child of pain and discomfort and to try and weed out the current infection through extractions.