My child is complaining of pain in a baby tooth, what should I do?

The first and most obvious answer is to take the child to the dentist as soon as possible so an exam and x-ray can be done.  A mistake I see parents make all the time is delaying a visit to the dentist because the tooth is “just a baby tooth.”  As we discussed previously, baby teeth are incredibly important to the overall health and relationship of the permanent teeth.  Not only are the baby teeth vital to future orthodontic relationship of permanent teeth, they can also have a devastating effect on the shape and color or the erupting adult tooth.  They also decay and abscess (the nerve in the tooth dyes, causing a localized infection) at a much faster rate than permanent teeth.

Baby teeth are no different from their permanent counterparts with respect to their ability to abscess and cause life threatening infections.  Of course we are worried about future orthodontics and damage to the underlying tooth, but I think we can all agree that a life-threatening infection in our children would rock our worlds.  Teeth can cause these scary abscesses because of their close proximity to the brain, spinal cord and neck.   These infections can be extremely difficult to treat because it is challenging to get antibiotics past certain barriers that are located in the head and neck.

So, if your child is complaining of a tooth ache, treat it seriously.  The dentist will generally take an x-ray to see if the baby tooth can be fixed or to see if it is due to fall out soon anyway.  If it is not close to falling out and the tooth looks to have a favorable prognosis with the proposed treatment, then your dentist will likely do whatever it takes to keep it.  I know it will feel like heroics for such a little tooth, but again, the goal is to save it for all the reasons we discussed earlier.  Some of the treatment options may be as follows: extraction of the tooth (with or without a space maintainer to hold the space for the permanent tooth), baby tooth root canal, and/or possibly a stainless steel crown.

If the dentist feels that the prognosis with treatment is poor and/or the chance for re-infection is high, they will likely opt for extracting the tooth.  If the underlying tooth is not due to erupt fairly soon after the extraction, the dentist may propose placing an appliance in the area of the extracted baby tooth to hold open the space.  This space is necessary in order to keep an open path for the permanent tooth to enter into normal alignment in the mouth.  Sometimes, the drifting of already erupted teeth into the extracted space can block the path of the permanent tooth and trap it permanently beneath the gums.  Once this occurs, extensive orthodontics and surgery are usually needed to bring it out.

This special appliance is called a “space maintainer” and is usually permanently glued to adjacent teeth so that the child can’t remove it.  If we gave them something removable, you would be throwing your money away due to noncompliance.  If you have had a teenager with braces who is now wearing a retainer, you know exactly what I am talking about!

There are many types of space maintainers and they are selected based on the needs of the child.  Some will only hold the space for one missing baby tooth while others may hold the space for multiple missing teeth and may even hold the space on both sides of the mouth.  Each space maintainer is custom built for the child’s particular needs.  The maintainer is usually removed once the permanent teeth make their appearance and the dentist feels confident that the space is no longer compromised

Two types of space maintainer devices:

Tags: Abscesses, Antibiotics, Baby Teeth, Baby Tooth, Close Proximity, Counterparts, Dyes, Favorable Prognosis, Heroics, Little Tooth, Localized Infection, Mistake, Nerve, Orthodontics, Permanent Teeth, Spinal Cord, Tooth Ache, Treatment Options, Visit To The Dentist, X Ray