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Decayed Baby Teeth — Save Them or Pull Them?

Your child's dentist has had the same conversation many times.

Dentist: "Your son, John, has a very large cavity in his second primary molar. To save the tooth, I will have to do a root canal and place a crown."

Parent: "Doc, it's a just baby tooth. Why don't you pull it?"

The reaction is a common one because most people don't realize the important role that primary (baby) teeth play in a child's life.

By the time most children are 3 years old, they will have 20 baby teeth. These teeth help the child chew and speak. They also maintain the spaces for the permanent teeth.

Tooth decay is caused by an infection. This infection in a baby tooth can also harm the permanent tooth that is growing under the baby tooth. This is why the dentist wants to treat John's diseased primary tooth.

If a child loses a baby molar (back tooth) too soon, the molar can no longer maintain the space for the permanent tooth that is growing between its roots. The tooth behind the lost molar will start to drift forward into the space. If this occurs, the permanent tooth may not have enough room to come into the mouth in a normal position. The child also will not be able to chew as well without this molar.

For these reasons, dentists advise trying hard to save baby teeth. But sometimes a baby tooth may be so diseased that it can't be saved. If this is the case, the dentist will extract (pull) the tooth.

The dentist may recommend a space maintainer. This device preserves the space of the missing primary tooth until the permanent tooth is ready to come in.

Of course, the best way to maintain baby teeth is to practice prevention. Proper brushing, flossing and regular visits to the dentist will help preserve your child's baby teeth until the permanent teeth are ready to replace them.

Reviewed by McManus December 23, 2015