I’ve been trying to find information about my 5 year old son’s dental problems. He has at least four teeth that need to be treated, and I have not yet located a dentist that can talk my son into getting a look in his mouth.
The first molars on the bottom both have cavities that look to be quite deep, and the second molars are worse. They have both lost tooth structure from decay. I’m pretty sure we are going to have to sedate him to get work done on these teeth, and I want to thoroughly understand all the options before I send him to a pediatric dentist.
When teeth have begun to literally rot out, do they have to be removed? Is there any sense in doing porcelain onlays or dental bonding on such a young child, or could white fillings be used to protect what is left of his teeth until they are replaced by his adult teeth?
Thanks very much for your help,
Michelle from Columbus
Dear Michelle,
You are right to be concerned about keeping those baby teeth intact. They are necessary, not only to help him eat, of course, but to hold the proper spaces for his adult teeth. If he loses those teeth, his permanent molars will drift forward, and cause crowding. This would likely cause a cascade of problems that could result in a lot of time, money and discomfort. If your son does need to have those teeth pulled, space maintainers should be used to keep his teeth aligned.
Perhaps a more difficult topic to address is the pattern of eating that probably produced this issue. Young children generally get a lot of cavities because they eat too frequently. The level of decay you describe makes it very likely that your son is a “grazer”–that he likes to eat small amounts pretty much constantly. This pattern of eating is almost always the culprit in severe tooth decay in young children.
Habits surrounding food are very challenging to break, but you would be doing your child and yourself a favor by nipping this kind of eating habit in the bud as soon as possible. If you don’t, you will continue to see issues with tooth decay which will become more serious when permanent teeth are involved.
Most dental work on baby teeth is considered a short-term solution, as those teeth will fall out when the permanent teeth begin to come in. For molars, that usually happens around age 11 or 12. A dentist will likely place a dental crown on the decayed molars, but not the same kind of crown that is used for adult teeth. Generally, a dentist will use a crown that is not as expensive, like a stainless steel or some other kind of prefabricated crown.
Look for a pediatric dentist who is experienced with sedation techniques, if that is what it will take to get this work done.