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Baby teeth come with a built-in expiration date. That charming first smile is meant to make way for a healthy, beautiful adult smile. Unfortunately, before they are ready to make way for permanent teeth, primary teeth can be affected by decay, trauma, or infection—problems which can lead to damage to the pulp within the tooth. If your dentist tells you that your child’s tooth needs specialized endodontic treatment, is treatment really that much better for your child than losing a baby tooth prematurely?

Quite often, the answer is yes!

Baby teeth do much more than serve as temporary stand-ins for adult teeth. They are essential for:

• Biting and chewing—a full set of baby teeth helps your child develop proper chewing, which leads to healthy digestion. And chewing also helps build face and jaw muscles.
• Speech development—primary teeth help guide speech production and pronunciation.
• Spacing—a baby tooth serves as a place holder for the adult tooth waiting to arrive. If a primary tooth is lost too early, the remaining baby teeth may drift from their proper location. This, in turn, can cause overcrowding or misalignment of the permanent teeth when they do erupt.

Baby teeth, like adult teeth, contain living pulp tissue. The pulp chamber inside the crown (the visible part of the tooth) and the root canals (inside each root) hold nerves, blood vessels, and connective tissue. When the pulp is damaged by trauma or infected, a baby tooth can still be saved with endodontic treatment. Endodontic treatment in baby teeth can take two forms.

• “Vital” pulp is pulp that can be saved. Vital pulp therapy uses procedures to deal with damaged pulp inside the crown, or visible part, of the tooth. Pulp therapy can be used on teeth when only the top of the pulp has been affected by decay, limited exposure, infection, or trauma, but the root pulp remains healthy. Specific treatment will depend on the nature of the pulp injury, and a crown will usually be placed over the tooth after treatment to protect it.
• With non-vital pulp, your dentist will probably recommend a traditional root canal procedure. All of the pulp tissue will be removed from inside the crown and the roots, and the pulp chamber and root canals will then be cleaned, disinfected, shaped, and filled. Finally, because the treated tooth will be more fragile, a crown will be used to protect the tooth from further damage.

There can be good reasons for extracting a seriously damaged baby tooth, and there are situations where preserving the tooth is the best and healthiest option for your child. Discuss your options with Drs. Don and Mindy when you visit our Charleston office for the safest, most effective way to treat your child’s compromised tooth.

Children’s baby teeth generally start to fall out when the adult teeth underneath them are ready to arrive. Visits from the Tooth Fairy begin around the age of six, and continue until the last baby molar is gone.

But sometimes, we can’t wait for nature to take its course, and children need a dentist’s assistance to remove a primary tooth before it falls out on its own. Here are some common situations where extracting a baby tooth is best for a child’s present—and future—dental health.

• Serious Decay

Dentists make every effort to save teeth, and this includes baby teeth. A filling or even the baby tooth version of a root canal can be used to save little teeth when a cavity appears.

But severe decay could mean that there’s not enough healthy tooth structure left to fill. Or that bacteria have caused infection inside the tooth. Left untreated, infections can spread to other tissues in the body and can become quite serious. When a primary tooth is seriously decayed or infected, an extraction is often the healthiest choice.

• Trauma

Sometimes a baby tooth will recover on its own if it’s been jarred by an impact. Sometimes an injured tooth can be repaired with treatment. If there’s serious damage, though, a baby tooth is at risk for abscess and infection, and, sometimes, can cause harm to the adult tooth beneath it. In cases like these, an extraction is the safest option.

When an injury causes a broken or dislodged tooth, call Drs. Don and Mindy immediately. Whether the tooth can be saved or should be extracted depends on how serious the injury is and how soon you can get your child to the dentist’s office or the emergency room.

Whenever a child loses a primary tooth early, a pediatric dentist will be on the lookout for potential orthodontic problems. Remaining baby teeth tend to shift to fill any empty spot. Without the proper space to come in, the adult tooth can erupt out of place or at an awkward angle. Drs. Don and Mindy  might recommend a space maintainer to keep baby teeth aligned properly and to make sure the right spot stays open for the permanent tooth when it’s ready to erupt.

We’ve talked about primary teeth which are lost early, but it’s also problematic . . .

• When a Baby Tooth Doesn’t Fall Out

Usually, a wiggly baby tooth is a clue that the adult tooth underneath has started pushing its way up and out. The baby tooth’s root is gradually absorbed as the adult tooth moves into place. Without an intact root to hold it in place, the baby tooth grows looser and looser until it falls out. Now the permanent tooth has the perfect open space ready for its arrival.

But when baby teeth don’t fall out on their own, this can be another source of orthodontic difficulties.

Stubborn baby teeth can mean adult teeth erupt behind them, creating a double row of teeth (colorfully known as “shark teeth”) and risking crowding and misalignment. Or a baby tooth can block an adult tooth from erupting at all. When that baby tooth just isn’t budging, an extraction will create space for the permanent tooth to erupt.

If an extraction is scheduled, consult with Drs. Don and Mindy about these important topics in advance:

• Preparing for the Procedure

A pediatric dentist is an expert not just in caring for little teeth, but in caring for little patients as well. Because extractions can be scary for children, talk to our Charleston dental team to learn how to prepare your child for the procedure in an informative, comforting, and age-appropriate way.

• Sedation Options

A local anesthetic could be all that’s necessary for a simple extraction. If sedation is recommended for an extraction, or if you feel sedation is better for your child’s needs, discuss nitrous oxide, oral medication, and other options with your dentist.

• Aftercare

Whether it’s how to protect the area around the extraction, which foods and drinks are best over the days following, or how to treat pain and swelling, you’ll be given clear instructions by your pediatric dental team to help your child recover comfortably and quickly.

Little teeth can take different paths on their way to the Tooth Fairy. Your pediatric dentist is an expert both in treating children’s dental needs and in making sure their oral development is on schedule. If your dentist has recommended an extraction, it’s because this is the very best way to protect your child’s immediate oral health while ensuring a healthy future adult smile.

If your child participates in sports or other physical activities, it’s wise to consider getting a mouthguard. Also known as mouth protectors, mouthguards are a device worn over the teeth to lessen the impact of a blow to the face.

This reduces the chance that your child might lose teeth or sustain other serious oral injuries. We recommend that all patients involved in a contact sport such as wrestling, football, or hockey wear a mouthguard because of the high risk of such injuries.

However, anyone involved in a physically demanding sport or activity should wear a mouthguard as well.

Can you imagine what it would be like to lose a few of your front teeth? The way you talk, eat, and smile would all change.

Injuries that can be sustained when not wearing a mouthguard include:

• Chipped and broken teeth
• Fractured jaws
• Root damage
• Concussions
• Injury to the lips, cheeks, or gums

Types of Mouthguards

There are three different types of mouthguards — typically made of a soft plastic material or laminate. You can decide which works best for your child in terms of budget, fit, and comfort.

• Stock mouthguards are prefabricated to a standard size. They offer adequate protection, but you need to find one that fits your child properly and comfortably. Stock mouthguards are readily available at department stores, sporting goods stores, and online.
• Boil-and-bite mouthguards are placed in boiling water to soften them, then into the mouth so they can conform to the shape of the teeth. Boil-and-bite mouthguards are more expensive, but offer a more customized fit than stock ones. You can find these in department stores, pharmacies, sporting goods stores, and online.
• Custom-made mouthguards are created just for your child by Drs. Don and Mindy. These offer the best fit and comfort of all the options, but they are also the most expensive. Ask a member of our Charleston team for more information.

The American Dental Association says a good mouthguard should be easy to clean, fit properly, be comfortable, and resist tearing or damage. It shouldn’t restrict speech or breathing.

Still not sure if your child needs a mouthguard or which kind is right for his or her smile? Ask Drs. Don and Mindy or one of our staff members for more information.

Your baby’s first smiles are precious—and you want to make sure those precious smiles are as healthy as they are beautiful. One of the most important ways to protect your child’s dental health is by preventing early childhood caries, or cavities.

You might be thinking, “Tooth decay? Babies?” Yes, babies and toddlers can get cavities, too. Studies suggest that over a quarter of children between the ages of two and five already have some form of tooth decay.

The bacteria that cause tooth decay are passed from person to person. Cavity-causing bacteria use the sugar and starches in our diets to produce acids—acids which attack the tooth’s enamel, breaking down its hard mineral structure until cavities form. Because baby teeth have thinner enamel coatings than adult teeth, they are especially vulnerable to tooth decay.

You can start your child on the path to a lifetime of healthy smiles by being proactive about cavity prevention during your baby’s first 12 months.

• Don’t Share Bacteria

Because cavity-causing oral bacteria are transmitted from person to person, doctors and dentists suggest that you don’t share a spoon with your baby, or put a pacifier in your mouth to clean it. And it’s a good idea to rinse toys used by other children with clean water before giving them to your child.

• Keep Bottles Out of Bed

Babies generally need a feeding before bedtime to ensure that they get all the nutrition their growing bodies need. But when a young child sleeps with a bottle, liquids pool in the mouth, exposing tiny teeth to these liquids throughout the night and preventing the natural flow of saliva from washing food particles away.

Bring your child’s happy day to a close with a lullaby, a bedtime story, a good night kiss, or whatever makes your baby feel comforted and loved—and take the bottle with you when you tiptoe out of the room.

• Avoid Sugary Drinks

How do parents make sure their babies get the nutrition they need without giving cavity-causing bacteria the fuel they need? With a healthy diet. Breast milk and formula have healthy nutrients, carbs, and sugars which are necessary for baby’s growth and development. Sugar water, sweet juices, and sodas—don’t.

Added sugars provide a feast for cavity-causing bacteria, and the more your child is exposed to them throughout the day, the greater the risk of tooth decay. Talk to Drs. Don and Mindy for the healthiest drinks for your baby’s bottle or sippy cup.

• Clean Baby’s Teeth and Gums

Dentists recommend cleaning your baby’s gums even before teeth begin to arrive. After washing your hands, using a clean, damp, soft cloth or gauze pad to gently wipe the gum surfaces to remove bacteria and food.

As soon as the first tooth appears, it’s time to start gentle brushing. Use a baby-sized toothbrush to gently clean the erupting teeth once in the morning and once after the last feeding of the day. And as soon as two baby teeth touch, it’s time to talk about flossing.

Not sure about baby-friendly tooth care products, toothpastes, and techniques? Talk to Drs. Don and Mindy! Learn about cleaning little gums, baby-size brushes, when to begin using fluoride toothpaste and how much toothpaste to use, when to brush, and when to start flossing.

• Establish a Dental Home for Your Child

The ideal time for your child’s first visit to our Charleston office is sometime between the appearance of your child’s first tooth and your child’s first birthday. It’s a gentle way to introduce your baby to the dental team who will be caring for those little smiles for many years to come.

During that first visit, your child’s dentist will check tooth and jaw development. There will be a child-friendly examination to look for plaque buildup or any signs of early decay, such as white spots on tooth enamel. You can talk about any concerns you might have and learn the best ways to prevent tooth decay with proactive dental care for healthy teeth and gums.

Why are we so concerned about baby teeth? Decayed teeth can cause pain and self-consciousness. And more, those tiny teeth have big responsibilities. Baby teeth influence your child’s speech development. They promote healthy eating and chewing habits. Baby teeth serve as placeholders to make sure that your child’s adult teeth will be able to erupt just where they should.

Your baby’s first smiles are precious. And when you’re proactive with early dental care, you’re preparing your child for a lifetime of healthy smiles.