space maintainer Archives - Kentucky Dental Group

Why Extract Baby Teeth

Posted on April 19, 2021 by writeradmin.

My six year old daughter has decay on two of her back molars. The dentist is being a bit rude and wants them extracted immediately, but they are baby teeth. Why is that the right choice? Won’t they just come out? Why pay to pull it?

Sara

Dear Sara,

There are a few things going on here. First, I will say I am sorry your daughter’s dentist was rude. I wasn’t there and don’t know your dentist, but is it possible it was more urgency that came across as rude? It is unusual for a children’s dentist to recommend that a back molar be extracted on a child that age. You mention decay. I wonder if that decay had turned into an infection. I know it is a baby tooth and they do come out, however back teeth are different for reasons we’ll go over in a moment.

Bear in mind, I have not examined your daughter, but here are some possibilities and what to do about them.

1. The teeth are deeply decayed and they going to break and lead to infection. If there is enough of the tooth left to save some of it, you could do a pulpotomy and place a dental crown on it. A pulpotomy is simply a child’s version of a root canal treatment.

You mentioned that their teeth come out. So you are likely now wondering why do a pulpotomy when you can just get rid of the tooth? While it is fine for most baby teeth to be removed prematurely, the back molars need to stay in place until she is twelve years old, when her next set of molars typically come in. In a six year span, her other teeth will drift toward the empty space, then when her adult molars finally do come in, there will not be space for them and it will turn into a crowding problem that needs orthodontics to fix. Getting the crown, will preserve that position so the adult teeth can come into the right place.

2. The tooth is already infected beyond what a pulpotomy can help. Tooth infections are considered dental emergencies. This is because the antibiotics cannot “treat” the infection only hold it back temporarily. If a dentist doesn’t get in there and remove the infected pulp, the infection will spread. Think about how close your daughter’s jaw is to her heart, lungs, and brain. Sadly, people still die of tooth infections, even though it is completely treatable.

If her decay and infection have progressed, then even though it is a molar the tooth will have to be extracted. If that happens, make sure to get a space maintainer. This is a device they can place which will keep the space protected so there won’t be crowding.

Because your daughter is likely already in some pain and you don’t want it to be a traumatic situation for her that makes her afraid of dentists for the remainder of her life, I recommend you go to someone who uses dental sedation. This way it will be an anxiety-free/pain-free experience for her.

This blog is brought to you by Lexington, KY Dentist Dr. Weaver.

Dental Flipper for a Pre-schooler

Posted on April 17, 2020 by writeradmin.

My son, who is three years old, had a fall which caused him to lose his two front teeth prematurely. I’ve heard that children need to keep their teeth in order to prevent shifting and crowding. My dentist said that won’t be an issue, but I’m still worried. I’m looking at dental flippers online and they only seem to make them for adults. What is your recommendation for a toddler?

Robin

Dear Robin,

Many general dentists will see entire families

While there are some teeth which have to stay in place until your son is around twelve-years-old or you risk shifting and crowding, that is only for his back teeth. If these teeth have to be removed prematurely, your pediatric dentist would need to place a space maintainer. Your son lost his front teeth. These teeth won’t have the same issue and he’ll be fine.

I want to discuss the dental flipper, though. Let’s say for argument’s sake that he did need a replacement. These are only made for adults for a reason. First, they are removable. This will be a choking hazard for a young child. Even if it weren’t a choking hazard there would be other issues.

Because it is removable, you would likely have a hard time getting him to keep it in his mouth. Plus, it clasps onto his teeth. At his age, his teeth and jaw are in constant flux and growth. You would have to constantly replace it.

I hope knowing the front teeth will be fine puts your mind at ease. I can tell you are a caring mother.

This blog is brought to you by Lexington, KY Dentist Dr. John Weaver.

Is a Pulpotomy Really Necessary?

Posted on January 31, 2020 by writeradmin.

My daughter has an infection on a baby molar. My dentist wants to do a pulpotomy on it. What I don’t understand is why we just don’t pull the molar. It’s not her permanent one. When I asked her dentist, he just said, “Because as her dentist I’m telling you this is the best option.” What I wanted to say was, “Well, as her parent I want to know why.” but I was too chicken. I’ve scheduled the appointment but I really want to know why before I follow through with this.

Jen

Dear Jen,

The answer to this really depends on the age of your daughter. Her baby molars need to stay in place until she is around twelve years old when her permanent molars come in. When they’re significantly younger than this, one option is to do a pulpotomy. This is essentially a child’s version of a root canal treatment. It will help her retain a necessary tooth.

Another option is to extract the infected molar, however, you will need to place a space maintainer where the tooth once was. This is a more invasive treatment, but sometimes becomes necessary when the tooth cannot be saved.

If you don’t do either of those, the infection will spread. Tooth infections are considered dental emergencies and need to be taken seriously. The jaw is close to the heart, brain, and lungs. You don’t want the infection to reach any of those areas.

If you extract the tooth without a space maintainer then her other teeth will shift into the open space. When her permanent molars start to come in, it will lead to crowding of her teeth. Then, you’re talking about needing orthodontics which could have been prevented. Keeping this space secured is much less expensive.

A Word about Your Pediatric Dentist’s Response

I’m not happy with your his response to your question. You are the parent and he is ethically obligated to give you all the options available in treatment. In doing that, it means also explaining the pros and cons to each option, along with his explanation for his recommendation.

His arrogance in being questioned makes me wonder whether he’s giving you any of your other options. This isn’t the best care for your child. While you need to get your daughter’s infection dealt with. I think you should start looking for a new dentist for her. If you live in a small town which doesn’t have many pediatric dentists, you can also see a general dentist who is good with children.

This blog is brought to you by Lexington, KY Dentist Dr. John Weaver.

Is a Pulpotomy a Necessity?

Posted on July 30, 2019 by writeradmin.

I have a child who has a large cavity. The dentist wants to do a pulpotomy. It’s a baby tooth. The tooth is going to fall out anyway so can’t we just let nature take its course? At the most, I’d think we could just pull it. I feel like this is an unnecessary procedure.

Stan

Dear Stan,

It sounds like your pediatric dentist isn’t very good at explaining the reasons behind his treatment recommendations. As for whether you can just let the tooth fall out, it really depends on how far gone the tooth is and where the decay has reached. For instance, if the decay has reached the pulp of the tooth, which I suspect it has, leaving the tooth in place to fall out on its own will lead to a severe infection.

Tooth infections are a dental emergency. Unless the infection is physically removed it will continue to spread. If you think about how close your jaw is to your heart and brain, you can see how a fast moving infection can turn life-threatening quickly.

Now, if it was a front tooth, just pulling it would be fine. Back molars are different. They have to stay in place until your child is around 12-years-old. Without that, the other teeth will shift which will cause severe crowding as his other teeth come in. Believe me, you do not want the added expense of braces if it can be at all avoided.

A pulpotomy is essentially a root canal treatment for children. It’s designed to remove the infection while still saving the tooth. There are times when the tooth can’t be saved. If your child’s decay progresses that far and the tooth has to be removed, make sure your pediatric dentist places a space maintainer there to keep the other teeth from shifting.

This blog is brought to you by Lexington, KY Dentist Dr. John Weaver.