Dr. Brad Hylan’s Dentistry Blog

My five-year-old daughter has large cavities in all of her upper molars. For some of them, about 1/3 of the tooth is gone. I have taken her to several dentists, and she hasn’t let any of them work on her teeth. What can I do?
Collette

Colette,
If you see 1/3 of a tooth gone, the decay is usually considerably more extensive than that.

When children that young have that many large cavities, it can be because of their eating patterns. Does she have frequent snacks all day long? Extensive tooth decay requires frequent feeding. Food passes through the mouth, and a meal will cause the activity of tooth decay bacteria for about twenty minutes. For that much decay, it requires feeding all day long.

For right now, you need to get her the dental care she needs. Your daughter may end up requiring sedation to get this work done. But get it done. If she loses these baby molars and nothing is done, her permanent molars will drift forward and block out her other permanent teeth, and her mouth will end up being a mess with teeth pointed in all directions because of the crowding that will happen.

Then, for the long term, I would try to encourage better eating patterns. These can be tough habits to break, but I would encourage you to tackle this. You may have to let her go hungry for two or three hours in order for her to build up enough appetite for a meal. Somehow you have to get her out of this pattern of constant snacking. It’s not only bad for her teeth, but snack foods are also not very nutritious, so this will help her in several ways.

Links:
Cleveland pediatric dentist.

My son is 20 months old, and has had trauma to his four front teeth. I believe that the trauma has caused severe discoloring to his teeth, because he never took a bottle or a pacifier (instead he was breastfed). Aside from the green discoloring, there is also wearing away of the enamel. I give him a childrens multi-vitamin everyday, but I fear it is not doing much good. Will I need to have his four front teeth extracted? I appreciate your time, thanks!
- Nikki from Ohio

Nikki,
I’m not sure I understand the relationship between your baby’s trauma and the bottle or pacifier. And it would help to know just what the trauma was. But let me see if I can still be helpful.

Green discoloring in baby teeth is probably from bacteria. Children can get these unusual stains on their teeth, and as their bodies get used to the various bacteria that are naturally in their environment, the discoloration goes away. I would take your baby to the dentist and have the teeth cleaned and examined.

The multi-vitamin may be a good idea, but it won’t have an effect on his teeth that are already erupted and in the mouth.

Trauma can cause the nerves in the teeth to be severed and then it may be necessary to have them extracted. But it’s best not to take them out unless it’s necessary, especially at the age of 20 months, because they are helpful for speech development.

Links to more information:
Dr. Hylan isn’t actually a Cleveland pediatric dentist, but he loves to treat children and is very experienced at it.
Read more about tooth extractions.

My six-year-old daughter has two baby molars that broke off because of decay. Our dentist says that they are infected and need to be extracted. Is there anything else that can be done?
Kristina in Wisconsin

Kristina,
Unfortunately, when baby molars get infected, they do need to be extracted. Because of the shape of the roots, it isn’t possible to do root canal treatments on them, so extraction is the only way to get rid of the infection. Left untreated, the infection will end up affecting the permanent teeth that are developing below the baby molars.

Your dentist will also be wanting to put in space maintainers to help hold the space. At age six, her permanent first molars are about to come in behind the baby molars. Unless there is some kind of space maintainer, the permanent molars will drift forward which will block out the permanent premolars from coming in normally, and it could end up being quite a mess. So be sure you do that.

Click here to see our Cleveland pediatric dentist page.