Managing Dead Baby Teeth: When to Extract or Treat?

Q: Managing Dead Baby Teeth: When to Extract or Treat?

Hello： If it is possible to perform a root canal treatment to save the tooth, that would be the best option. <br>I suggest you give it a try; how will you know it won't be successful if you don't attempt it? Even if it doesn't work out, it won't be too late to extract the tooth a

Deciduous tooth necrosis, with swollen gums and pus?

Last April, my daughter fell and chipped a corner of her upper front tooth.
Three months later, the tooth turned black, and the dentist said it was dead.
Another three months passed, and the gums around the dead tooth became swollen and had pus.
An X-ray was taken, and it seemed that the root or permanent tooth wasn't damaged (I can't remember).
The dentist mentioned that since my daughter is still young (three years old), it will take a few more years for her to lose her baby teeth, and since she isn't experiencing any pain, they decided to leave the baby tooth as is.
However, my daughter's gums have been swelling and subsiding repeatedly for a total of seven months, and I am really concerned.
Today, I took her to see another dentist, who took one look and said the tooth needs to be extracted.
I understand that extracting the tooth is a definitive solution, but she is not yet four years old, and having her front tooth removed at such an early age could lead to misalignment of her permanent teeth in the future.
Plus, it looks quite strange for her to be without a front tooth at such a young age.
The dentist mentioned that if we want to keep the tooth, a root canal treatment would be necessary, but such treatments on baby teeth often have a low success rate.
Could you please provide some advice? Thank you.

umyuc, 20~29 year old female. Ask Date: 2010/04/21

Dr. Zhuang Suhui reply Dentistry

Hello: If it is possible to perform a root canal treatment to save the tooth, that would be the best option.
I suggest you give it a try; how will you know it won't be successful if you don't attempt it? Even if it doesn't work out, it won't be too late to extract the tooth afterward.

Reply Date: 2010/04/21

More Info

Managing dental issues in young children, particularly with "dead baby teeth" or non-vital primary teeth, can be quite challenging for parents. Your daughter's situation, where her upper front tooth has turned black and the surrounding gums have been swollen with pus, indicates a significant dental issue that requires careful consideration.

When a primary tooth becomes non-vital, it can lead to various complications, including infection, abscess formation, and potential impact on the developing permanent teeth. In your daughter's case, the fact that the tooth has been non-vital for several months and the recurrent swelling of the gums suggests that there may be an ongoing infection. This is concerning, as untreated infections can lead to more severe complications, including the spread of infection to surrounding tissues or even systemic issues.

The decision to extract or treat a non-vital primary tooth often depends on several factors, including the child's age, the condition of the tooth, the presence of infection, and the potential impact on the permanent teeth. In general, if a primary tooth is non-vital and symptomatic (e.g., causing pain, swelling, or pus), extraction is often recommended, especially if the tooth is unlikely to be saved through root canal treatment.
Root canal treatment in primary teeth can be complicated and may not always be successful, particularly in younger children. The success of such treatments can be influenced by the child's cooperation, the extent of the infection, and the anatomy of the tooth. If the tooth is severely infected or if there is a risk of the infection spreading, extraction may be the best option to ensure the child's overall health.

While it is understandable to be concerned about the aesthetic impact of losing a front tooth at such a young age, it is essential to prioritize the child's health. The absence of a primary tooth can be managed with space maintainers if necessary, and the permanent teeth will eventually come in. It is also worth noting that primary teeth are meant to fall out naturally, making room for the permanent teeth, which will erupt in due time.

If you are worried about the potential for misalignment of the permanent teeth due to early extraction, consulting with a pediatric dentist who specializes in this area can provide you with more tailored advice. They can assess your daughter's dental development and discuss options for space maintenance if extraction is deemed necessary.

In summary, while the extraction of a non-vital primary tooth may seem drastic, it is often the safest and most effective option to prevent further complications. If you have concerns about the timing or implications of the extraction, seeking a second opinion from a pediatric dentist may provide additional reassurance and clarity on the best course of action for your daughter's dental health.

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