The Digital Dental Surgeon

A mother brings her 4 year old child to a dental clinic.

I would like the doctor to take all the decayed teeth out

The child looked slightly uncomfortable, being in the clinic for the first time. And yes, there are quite a number of milk teeth that are decayed and needed treatment.

Decayed teeth in a child are not treated as easy as having them extracted. It is true that at the right time, the milk teeth will be replaced with the permanent teeth but that should not be the reason for extraction.

When a chlid loses his or her milk teeth way before the eruption time of the permanent teeth, the adjacent milk teeth will begin to move and try to close the space left by the extracted milk tooth.

Now on one hand it is good that the spaced is closed, there would not be a gap which could effect the aesthetics. On the other hand, closing the space by other milk teeth would then prevent the successor to erupt in the correct alignment which would then result in malpositioned tooth or crowding.

I would recommend that milk teeth should be kept in the mouth as long as possible, till it is the time for the permanent teeth to erupt. If there are decay present, have it treated by having fillings done or if necessary have pulpotomy done.

Pulpotomy is a treatment that removes decayed pulp of the milk teeth and rendering it non-vital. This should enable the milk tooth to be in the mouth painless until it is time to have it taken out.

Below is a chart for the eruption time of the permanent teeth.

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