I am a little frustrated with our pediatric dentist. First, he got onto me about the amount of decay on my 6 year old’s teeth. I have him brush, but it never seems to help. He acted like I neglected him. Second, he’s saying that he needs a lot of dental work, including three fillings, a pulpotomy, two tooth extractions, and a space maintainer. This is going to cost a pretty penny and I don’t understand why it is even necessary. Aren’t those teeth just going to fall out anyway to make room for adult teeth?

Margaret

Dear Margaret,

I’m glad you wrote. Let’s start with the decay. If he’s brushing every day (twice a day) and you take him to the dentist twice a year, then obviously you are doing everything that you know how to do. One thing that will help has more to do with food than hygiene. Your son’s saliva is a secret weapon against tooth decay because it contains bacteria fighting minerals. However, if he is snacking a lot or drinking a lot of sugary drinks, such as juice or soda, then his saliva doesn’t have time to do its job.

When you can’t explain the amount of decay, try reducing his snacking to once a day and making sure he is drinking mostly water. It may be challenging the first few days if he is not used to that, but there are great payoffs for standing firm. Aside from significantly less decay, he’ll also get better at eating during regular meal times.

What About All That Dental Work?

While it is true that his baby teeth will fall out, his back teeth need to stay in place until he is around twelve years old. If they come out prematurely, it will cause his other teeth to shift into the empty space. This will lead to overcrowding as his adult teeth erupt, which also means expensive orthodontics for you.

If your pediatric dentist is doing a space maintainer, I am going to assume that means one of the teeth being extracted is a back tooth. The space maintainer will help keep that space available for when his twelve year molars come in. Depending on the significance of the decay and whether or not there is an infection present will determine the need for the other treatments, such as the pulpotomy or the fillings.

A pulpotomy, which is a child’s version of a root canal treatment, tells me that something has blown up into an infection. If that is the case, you will definitely want to get the procedure. People still die from untreated tooth infections. This isn’t something to mess around with.

This blog is brought to you by Marietta Dentist Dr. Cristi Cheek.