At six months, the first little tooth erupts in most babies, and by two and a half years at the latest, all twenty milk teeth are visible. Baby teeth are important – they enable chewing of solid food, promote proper language development, hold space for permanent teeth and are important for the child’s psychological development.
Caries cases decrease thanks to prophylactic measures
According to a German Oral Health Study, the number of caries-affected permanent teeth in children has dropped significantly in recent years thanks to improved prophylaxis measures such as fissure sealing. However, it still happens that inadequate care of milk teeth or frequent use of caries-inducing drinks in nipple bottles attack and destroy milk dentition.
Have milk teeth caries treated
Once individual teeth or the primary dentition are decayed, it is imperative that they be remediated quickly. “This prevents the caries from spreading,” explains Dr. Dietmar Oesterreich, proDente expert and dentist. “It also eliminates possible unpleasant sequelae and reduces the caries risk for the permanent dentition,” Dr. Oesterreich continues.
Heavily destroyed deciduous teeth require a great deal of technical effort. Parents should bear in mind that children are not always ready for such extensive treatments. In addition, further diagnostic measures such as X-rays of children’s teeth are not always easy to perform.
Filling or crown?
The possibility of restoration depends on the degree of destruction of the deciduous tooth. “If the damage is small to moderate, plastic fillings are usually used,” Dr. Oesterreich reports from his practical experience. However, the reliable filling technique requires some time and needs the good cooperation and patience of the little patient. If the tooth is severely destroyed, in many cases the only solution is a prefabricated steel crown, which is fabricated under local anesthesia. It is primarily used for deciduous molars.
Get to the root
In case of deeply destroyed teeth, endodontic treatment is often necessary in the primary dentition. It is advisable if the nerve of the tooth is affected and the tooth is not yet subject to physiological tooth change in the foreseeable future. In this case, under local anesthesia, a part or even the nerve is completely removed from the tooth and replaced with a filling. Such extensive treatments are performed only if it is guaranteed that the germ of the permanent tooth will not be damaged.
Last resort: the extraction of the tooth.
Only when the dentist is convinced that rehabilitation is not advisable after making a precise diagnosis and recording the findings, will he advise the child’s parents to prematurely extract the defective tooth. “In some cases, premature extraction is even indicated, for example if the deciduous tooth prevents the permanent tooth from erupting or if orthodontic treatment is planned,” Dr. Oesterreich knows.
But it may also be that an appropriate gap retainer or a child’s prosthesis has to provide the necessary space for the permanent teeth. Modern dentistry therefore offers numerous options for restoring oral health, even for the youngest children. However, it is best if these are not used in the first place.
This is because every intervention is associated with stressful measures for the children concerned: X-rays, local anesthesia, possibly even general anesthesia. For this reason, parents should attach the greatest importance to regular care of the milk teeth and a tooth-healthy diet from the very beginning.