Do we fix cavities even if the baby tooth will fall out?

I get asked this question by parents multiple times each day without fail.  Understandably so when I have to tell them that their 4-year-old child has several cavities.  The belief is that the baby tooth should fall out before it causes any problems.  However, this is a fallacy and false hope that parents carry in many cases.

There are many reasons for taking care of baby teeth and they are quite different from the patient’s and dentist’s point of view.  It is obvious from the child’s perspective that teeth provide some of the most important functions to life, survival, and social interaction.  With poor teeth, your child will be hard-pressed to eat, drink, speak, and smile.  It would be devastating if your child could not do one of these.

From the dentist’s perspective, baby teeth maintain the space for the adult teeth that are to follow.  Whenever a baby tooth comes out prematurely, usually due to extraction by the dentist of an extremely decayed tooth, the adjacent teeth will start to shift.  space lossIn general, teeth like to move forward and out of their socket.  When baby teeth shift and tilt into spaces where another baby tooth was extracted, your child will lose space for the adult tooth to come in properly (please see the picture to the right).  This translates into the definite need for braces as well as a costlier and lengthier treatment period with braces.

Now that we know why baby teeth are important, I will explain the misconception of baby teeth falling out before causing any issues.  To begin, your child’s baby canines and molars, which are the most important teeth for guiding the adult teeth into the right place, do not exfoliate until 10-12 years old on average.  Next, baby teeth have thinner enamel and dentin compared to adult teeth, and the dentin is not as mineralized or as strong as in adult teeth.  All these factors coupled together – thinner teeth, less strong teeth, and quite some time before the baby tooth falls out – make it easier for cavities to progress to the nerve of your child’s baby tooth and necessitate an extraction.

So if your child has a cavity, do not wait on it.  Take care of cavities when they are small, even if your child is very young.  When tooth decay is small, a filling can be placed in a short amount of time and often without having to get your child numb.  When waiting to fix a cavity until your child is in pain, it usually is a sign that the tooth may have to be extracted.  Let’s not get to that point.

If you have any questions about the importance of your child’s primary teeth and the need to treat cavities, please contact Lil Pearls Pediatric Dentistry.


Blog by Lil Pearls Pediatric Dentistry, proudly serving Queens, Forest Hills, Rego Park, Middle Village, Elmhurst, Corona, Kew Gardens, and NYC.  Please call to schedule your appointment.

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