I have had parents ask me about children’s teeth. They want to know if the “baby” teeth are really worth treating since they will be falling out at some point. This is a fair question.

There is an entire specialty of dentistry for treating children, pedodontics, with an organization just for this specialty, the American Academy of Pediatric Dentistry. The mission of the AAPD is to advocate policies, guidelines and programs that promote optimum oral health and oral health care for children.

About Primary Teeth

Here are some guidelines for parents who may not know about their children’s teeth.  For those parents who love to track and document events in their children’s lives, the following may be interesting:

Baby teeth come in between 6-12 months, and the baby is usually pretty sore from “cutting” the teeth. Around the age of 6, the 4 front upper and lower incisors  fall out and the permanent teeth will come in. I’ve seen them come in at age 4 and as late as age 8. The 4 permanent first molars will come in at age 6 as well, but these do not replace any baby teeth. They’re much bigger than baby teeth, so while cutting them the teeth can become pretty sore.

The primary (baby) molars and canines fall out between 10 and 14, and permanent teeth will come in. The primary molars are replaced by premolars, also known as bicuspids (they have 2 cusps, or mounds of tooth structure for chewing). The primary canines are replaced by permanent canines.

The second permanent molars come in around age 12, and the wisdom teeth, or third molars come in at age15 or later—these are not very predictable.

So, what happens if decay is not treated on primary teeth?

The first bad thing is that the decay can spread and cause a toothache. These are no fun! And if still untreated it can lead to an abscess which is an infection around the tooth. To save the tooth and pulpotomy or pulpectomy would need to be performed (this is root canal treatment for a baby tooth; the nerve inside the tooth is removed so that the tooth doesn’t hurt any more).

What happens if the baby tooth is extracted well in advance of when the permanent tooth is due? The teeth will tend to shift forward and close the spaces where the permanent teeth are supposed to come in. The end result can be a real mess requiring tricky orthodontics. And all that was needed was a simple filling before the decay spread!

So, this is just an introduction to the basics of why baby teeth should be treated promptly.