Should My Child's Cavity in Primary Molar Be Treated or Extracted?

Cavity in the first primary molar?

Hello, the child is currently 8 years and 3 months old and has a cavity in the upper left first primary molar (all other teeth are intact).
The doctor recommended root canal treatment and a crown.
If root canal treatment is not performed and only filling is done, there may be tooth pain.
However, the child has already lost all primary teeth except for the upper left lateral incisor, which has not yet erupted.
It is estimated that the child will lose the primary molar by age 9.
Is it possible to avoid root canal treatment and the crown, and if there is tooth pain, simply extract the tooth? I found conflicting information online, so I am inquiring here.
Thank you for your help!

kagi, 0~9 year old female. Ask Date: 2013/12/16

Dr. Qiu Qiongyao reply Dentistry

Hello, Ms.
Wang.
Generally speaking, for severely decayed teeth, it is recommended to place a crown after root canal treatment to strengthen the compromised tooth structure.
Regarding your child's dental condition, I am unable to provide a definitive diagnosis as I am not a clinical practitioner.
My suggestion would be to seek a second opinion from another dentist if you have any doubts about the initial diagnosis.
Please note that information found online can sometimes be anecdotal rather than provided by professionals and may not necessarily apply to your son's situation.
Thank you for your message.

Reply Date: 2013/12/16

More Info

When considering whether to treat or extract your child's cavity in the primary molar, there are several factors to take into account. Your child is currently 8 years and 3 months old, and the left upper first primary molar has developed a cavity. The recommendation from the dentist is to perform root canal treatment followed by a crown, which is a common approach for preserving the tooth and preventing further complications.

Understanding the Options
1. Root Canal Treatment (RCT) and Crown: This procedure involves removing the infected pulp tissue from the tooth, cleaning and disinfecting the root canals, and then sealing them. Afterward, a crown is placed to restore the tooth's function and protect it from further decay. This option is generally recommended when the cavity is deep enough to affect the pulp, as it can prevent pain and infection, allowing the tooth to remain functional until it naturally falls out.

2. Filling: If the cavity is not too deep and does not involve the pulp, a filling might be sufficient. However, as your dentist mentioned, if the cavity is deep, simply filling it might lead to pain or further complications down the line.

3. Extraction: Extracting the tooth is a viable option, especially if the tooth is severely decayed and cannot be saved. However, it's important to consider that primary molars play a crucial role in maintaining space for the permanent teeth. Losing a primary molar prematurely can lead to misalignment of the permanent teeth, which may require orthodontic treatment later on.

Factors to Consider
- Timing of Tooth Loss: You mentioned that your child will likely lose this primary molar around the age of 9. If the tooth is extracted now, it may lead to space loss, which could complicate the eruption of the permanent teeth.
- Potential for Pain: If the tooth is left untreated and the cavity progresses, it could lead to pain and infection, which would necessitate emergency treatment.
- Future Dental Health: Maintaining the primary molar until it naturally falls out can help ensure that your child's dental arch remains intact and that the permanent teeth have adequate space to erupt properly.

Conclusion
In conclusion, while extracting the tooth may seem like a straightforward solution, it is generally advisable to consider the long-term implications for your child's dental health. If the tooth can be saved through root canal treatment and a crown, this option is often preferable. It can prevent pain, maintain space for the permanent teeth, and contribute to overall oral health.

If you are still uncertain, it may be beneficial to seek a second opinion from another pediatric dentist. They can provide additional insights and help you make an informed decision that aligns with your child's best interests. Ultimately, the goal is to ensure that your child has a healthy and functional set of teeth as they grow.

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