Would You Rather Your Young Child Have A Baby Tooth Root Canal Or Baby Tooth Pulled?

If you’re like most moms I’ve spoken with, you think that baby teeth are disposable teeth. You take care of them to a certain extent and see how much mileage they can give your child.

So if something goes wrong with your four-year-old’s baby molar like in the picture, you might reason that it’s going to fall out anyway so just have the baby tooth pulled, right? You wouldn’t invest much into baby teeth if push came to shove.

If I just described you, please read on. Trust me, it’s important.

I think it’s great that we have these baby teeth while we’re learning how to take care of them. In humans there are normally 20 baby teeth, but there are typically 32 permanent teeth, and some of these permanent ones begin to develop right around the time of birth.

It takes a very long time for teeth to develop within the jaw bones, then come into the mouth (eruption) and then develop roots and get all settled into place. Years. I mean MANY LONG YEARS.

And the whole time there’s a biological symphony going on both beneath and above the gumline between the baby teeth and the permanent teeth and the bones within which they grow. It’s a miracle to watch, and things are constantly moving in very… slow… motion. It can take more years to get a fully developed set of permanent teeth than there are baby teeth to start with (that would be 20… wink wink)

So what’s the problem with pulling the baby teeth prior to their getting loose on their own? Potentially a lot. It can create dental nightmares years later that you can’t imagine at the time your young child’s tooth has an owie you want to fix as cheaply as possible, such as:

• crowding of permanent teeth
• abnormal spacing
• poor jaw bone development
• creating circumstances where cavities are more likely to develop in the future
• the need for future surgery that might have been avoided

The teeth and jaw bones develop together, just like one big happy family. They both influence each other. In fact, parts of your child’s jaw bones (we call it the alveolar bone) really only develops in response to the roots of teeth being there.

With all this motion and growth happening over many months and years, if we intervene too early by pulling a baby tooth before its natural time to fall out, there are two general rules about teeth growth that might just bugger the whole system up:

1. Most teeth in the back and sides of the mouth tend to move forward in the mouth, both by tipping and eruption
2. Most teeth will continue to erupt until they have a reason to stop (such as hitting their opposing tooth above or below)

These things happen well into adulthood, but they happen REALLY rapidly during childhood years.

Here’s a really common scenario. If your young child gets a big cavity in her baby molar and you decide to have that tooth pulled, there will be several years for the teeth behind it to move forward in a drastic fashion. I only wish I could show you via slow motion video, but dentists witness this routinely. The permanent tooth beneath the baby tooth that was pulled can actually get trapped down in the jawbone and possibly require surgery to remove. This can lead to all the bad things I mentioned previously.

So an alternative is to do a root canal on the badly decayed baby tooth instead. This preserves the baby tooth roots until that tooth is ready to fall out on its own. In other words, this is sometimes the best thing to do… invest in your child’s baby tooth with a root canal.

Is this always the case? Not at all. Only you and your child’s dentist can weigh up all the factors in your particular situation. But now you know why these options might be so important to consider. Hopefully, the situation will never arise in your family.

In fact, in Real Mom’s Dental Community, mom Julie asked a question about why her four-year-old had these types of problems when none of the child’s older siblings had ever had them. Her question is what prompted me to write this post.

If you’d like to find out how I answered Julie, click here to watch the video. My response is at the end of that video.