Why Do We Put Fillings in Baby Teeth?

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As we get back into the routine of the school year, I thought we could get back to basics in dentistry. I had a parent recently ask, “If baby teeth are just going to fall out in a few years, why do we need to fill a cavity in a baby tooth?” That question comes up all the time from parents of all walks of life, and it is layered. The question also asks the value of baby teeth and an intact smile, it calls up parent memories of their own baby teeth and dental experiences. It often reveals a reluctance to have dental materials in the mouth, and a parent’s perception of a child’s ability to receive a filling. And of course cost; no one wants to spend money on a useless event.

Luckily, as a Fort Collins pediatric dentist of many years, I can answer those questions. My cell phone is always available for a chat on this subject. Let’s bullet point of few facts:

1. Fillings are technically difficult, no one does them for fun.
2. Dental caries is an infectious, chronic, bacterial disease that will spread from baby teeth to permanent teeth.
3. We do fillings on children in the office from 2-16 years every day. Your child is capable.
4. The best way to save money in dentistry is to enter into a long term relationship with a dental office based on trust and education.

Cavities, or small caves, are the end result of a bacterial infection caused by specific types of bacteria we cannot get rid of once in our mouths. Mechanical cleaning and use of fluoride products reduce the bacterial count and strengthen the tooth’s structure using minerals in our saliva. You get a hole in a tooth, bacteria exponentially reproduce in a non-cleansable area, and the infection spreads into the tooth and from tooth to tooth. That’s how it works.

Unfortunately for baby teeth, they are wired with blood and nerve tissue. Cavities hurt. Your child may not know what or where the hurt is coming from, but cavities hurt. The first tooth will fall out at age six for most, (oftentimes a front tooth) and the last baby tooth will fall out at age 12. For teeth that are loose or near to coming out, we DON’T place fillings on them if they have cavities, but we do everything we can to stop the spread of that decay. So when I prescribe a filling, the removal of decay and the placement of a plastic filling you can keep clean, I am telling you that the tooth will cause problems for your child if not done.

If there was any other option, including pulling the tooth, I would tell you. Really. It is my job to educate parents and kids (two different undertakings). And the way my office profits is by forming a long term relationship with patient families so they keep coming back. I have never taken a business class, but that’s what I know. Yes, it sounds a lot like the Golden Rule my father was always telling me growing up. It’s a different time that we can discuss the utility of baby teeth. Like most organs of the human body, it turns out their use (and timely loss) is critical to proper oral development and health!

And, for the health wonks, a word on dental materials. We use composites for fillings, they are a combination of plastic and glass that bonds to a tooth and wears like a tooth. They don’t have BPH, which never actually was included in any US dental materials, just Europe. We use stainless steel and ceramic crowns if fillings won’t work. I don’t remember much from my chemistry degree, but I know these materials extensively, so please ask a question in you have one! We goof around with kids a lot at Big Grins, but our practice is based on sound science and time worn experience. I hope this rather serious look at a common question helps the person who asked it, and you!


Greg Evans