Pediatric Dental Care: Cavities, Treatments, and Fluoride Safety - Dentistry

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Hello Dr.
Liu: My son is 5 years old and has 4 cavities in his front teeth, with 2 of them broken halfway.
I took him to see a doctor, who said that the decayed parts should be filled first before placing crowns, and that the other 2 front teeth need to be extracted and have root canals.
Isn’t it true that children lose their teeth around age 7? Besides, he hasn’t complained of any tooth pain! The teacher at school has been applying fluoride treatments; are there any side effects for children? Also, is it okay to apply fluoride if the child has a cold?

Miss He, 20~29 year old female. Ask Date: 2005/09/26

Dr. Liu Tiancai reply Dentistry


Hello: Children's primary teeth have permanent teeth developing underneath, so it is important to keep them clean to prevent internal infections that could affect the permanent teeth.
(There is usually no need for crowns.) If there is nerve necrosis, root canal treatment or extraction should be performed to prevent bacteria from invading and harming the permanent teeth.
Fluoride application has no side effects and can be done even if the child has a cold.
Sincerely, Dr.
Liu Tian-Cai, Dentistry.

Reply Date: 2005/09/26

More Info


Hello! Thank you for your questions regarding pediatric dental care, particularly concerning cavities, treatments, and fluoride safety. It's great that you're proactive about your child's dental health, especially at such a young age.

Firstly, regarding your son's cavities, it's not uncommon for young children to experience dental decay, especially with the prevalence of sugary snacks and drinks. The recommendation from your dentist to fill the cavities and possibly place a crown on the affected teeth is a standard approach. The reason for this is that primary teeth (baby teeth) play a crucial role in the development of a child's mouth and jaw, as well as in guiding the permanent teeth into their correct positions. If a tooth is severely decayed, it can lead to pain and infection, which is why your dentist may suggest root canal treatment (pulp therapy) for the teeth that are significantly affected.
You mentioned that your child is only five years old and that he will eventually lose these teeth. While it is true that children typically begin losing their primary teeth around age six or seven, the timing can vary. Some children may lose their teeth earlier or later, and maintaining the health of the primary teeth is essential until they naturally fall out. If the teeth are not treated, the decay can worsen, leading to more severe complications, including pain and potential infections that could affect the permanent teeth.

As for fluoride treatments, they are generally safe and beneficial for children. Fluoride helps to strengthen tooth enamel and can reverse early signs of tooth decay. The fluoride treatments administered at school are typically applied in a controlled manner, and the benefits usually outweigh the risks. However, it is essential to ensure that your child does not swallow excessive amounts of fluoride toothpaste or treatments, as this can lead to dental fluorosis, which affects the appearance of the teeth.
If your child is currently experiencing a cold or any illness, it is usually safe to proceed with fluoride treatments, but it is always best to consult with your dentist or pediatrician. They can provide personalized advice based on your child's health status.

In addition to fluoride treatments, maintaining good oral hygiene at home is crucial. Encourage your child to brush their teeth twice a day with a fluoride toothpaste, and supervise them until they are old enough to do it effectively on their own, usually around age 7 or 8. Limiting sugary snacks and drinks can also help prevent cavities.

Lastly, if you have concerns about the treatments your child is receiving or the potential side effects of fluoride, don't hesitate to discuss these with your dentist. They can provide you with detailed information and reassurance regarding the safety and efficacy of the treatments.

In summary, addressing cavities in young children is vital for their overall dental health, and fluoride treatments are a beneficial preventive measure. Regular dental check-ups and good oral hygiene practices will help ensure that your child's teeth remain healthy as they grow. If you have any further questions or concerns, please feel free to reach out to your dental care provider.

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