Do Cavities in Baby Teeth Really Need to Be Filled?

child being checked for cavities

What Happens if You Don’t Fill a Cavity on a Baby Tooth?

Alpharetta, GA – You’ve just taken your child to a pediatric dentist, only to find that they have a cavity in a baby tooth. A common question we get from parents is, “Since that tooth is just going to fall out anyway, can’t you just let the cavity go instead of going through all the trouble associated with filling it?”

“As I’ve discussed in other blogs, baby teeth are extremely important and should be cared for just like the permanent teeth,” says Alpharetta Children’s dentist Dr. Nanna Ariaban. “They help your child eat and speak properly and ensure the permanent teeth are healthy and can erupt properly.”

So, is it necessary to have a cavity filled? Dr. Nanna says yes, with certain exceptions.

For small cavities, there is a possibility that they can repair themselves through remineralization. If your pediatric dentist catches the cavity when it has just started, your dentist can give you tips to help better care for your child’s teeth and hopefully prevent the cavity from growing larger. This will include a proper dental-friendly diet and oral hygiene habits.

Next, if the pediatric dentist determines that the tooth is close to falling out, it may not be necessary to fill it. If your child seems like they won’t have their tooth for very much longer, the dentist may recommend just allowing the tooth to fall out without repairing it.

“But it’s important that parents follow the advice of a well-trained pediatric dentist, who has the unique knowledge of treating children,” says Dr. Nanna. “Our opinions are informed by years of careful study and treatment, and we know what can happen when decay is left untreated.”

Related Article: What are Cavities?

A 2014 report from the American Academy of Pediatric Dentists revealed that by age 5, nearly 60% of children in the U.S. will have experienced some level of tooth decay. The same report stated that when left untreated, this decay can lead to infection, difficulty chewing, and even malnutrition. Other studies show that children who have dental decay often experience difficulty in school due to the pain associated with the problem.

“It wasn’t that long ago that children didn’t come for their first dental visit until the late toddler or early preschool years when they had a mouthful of teeth,” says Dr. Nanna. “But, we saw the rate of childhood dental caries continue to increase, so now it is recommended that children see a pediatric dentist for the first time by the first birthday. This way, we can work with parents to develop good oral hygiene habits, help with dietary tips, and monitor the teeth so we can intervene before an issue becomes a big problem.”

But why do parents need to take the time and spend the money to fix teeth that will just fall out eventually anyway? Tooth decay is a disease, plain and simple. It’s caused by specific germs and can be spread easily, and it can last a lifetime. And if the baby’s teeth have serious decay, the permanent teeth can become damaged even before they erupt.

Do Fillings in Baby Teeth Prevent Problems in Permanent Teeth?

There may be some considerations that getting a cavity filled or treated would be a waste of money because baby teeth aren’t even permanent teeth, but it’s important to understand the long-term problems that come from lack of treatment.

Primary, or baby teeth, are of a different consistency and thinner than adult teeth. Therefore, they require more attention when it comes to brushing, flossing, and oral care. Cavities can quickly progress into very large cavities and can cause the need for baby root canals and crowns. If untreated, this can form into dental infections, causing pain and swelling.

It’s also important to help children keep their baby teeth as long as they can because they help guide the development and positioning of your adult teeth. Primary teeth that must be pulled or are so infected they fall out can create orthodontic problems, which accentuate the need for braces or other orthodontic procedures. This can make your child need longer orthodontic treatment or even make children who didn’t need braces be forced to get braces to correct their smile.

Other Problems That Cavities Can Cause When Untreated

Besides the impact that baby teeth can have on the placement of permanent teeth, fillings for baby teeth are a waste of time there are other consequences of leaving cavities untreated in baby teeth. These include:

Impede strong nutrition: Not treating cavities can cause eating to be painful and uncomfortable. Children that experience pain when eating will avoid wanting to eat and this will start to affect their overall nutrition. Some healthy foods can naturally be hard, including apples, carrots, and celery. However, if a child is unable to eat these hard foods because of pain in the mouth, they will start to lose essential nutrients that are important for their overall health.

Affected Speech: Untreated cavities can also lead to problems with speech. Teeth are part of speaking and can affect the sounds that children can make when speaking. However, if they have cavities and have teeth rot and fall out, it can begin to cause speech impediments that will affect the child’s ability to speak properly and can have lasting effects on their confidence in public speaking and communicating with others.

Self-Confidence and Appearance: Discolored or missing teeth can lead to children developing a poor self-image of themselves. If they feel that their smile or teeth don’t look healthy or white, they may begin to refrain from smiling and wanting to show their teeth. This lack of confidence in their appearance will have a lasting effect on their belief in themselves and their social lives.

Spreading Infections Across Other Teeth: Cavities can and will spread to other teeth if untreated. It is commonly thought that cavities are unlike other diseases or infections, that they cannot be spread. Cavities surely can and will spread to other teeth in the mouth if untreated. Cavities can also be spread to other people! It is important to treat cavities, so they not only destroy a tooth but that do not set off other cavities in the mouth.

How Do I Spot When My Child Requires Dental Fillings for Cavities?

It’s always harder spotting cavities early when it’s not your own mouth. However, if your child is complaining about sensitivity or pain in their mouth, it may be caused by the formation of a cavity. If your child complains about sensitivity or pain when they eat foods that are cold or hard, it can signal cavities.

The Mayo Clinic lists the following signs of cavity formations:

  • Toothache, spontaneous pain, or pain that occurs without any apparent cause
  • Tooth Sensitivity
  • Mild to sharp pain when eating or drinking something sweet, hot, or cold
  • Visible holes or pits in your teeth
  • Brown, black or white staining on any surface of a tooth
  • Pain when you bite down

You will want to check the tooth to see if there is plaque build-up or any discoloring. If so, then it would be good to schedule an appointment for a cleaning and check-up so that the dentist can treat it earlier.

If your child is visiting a pediatric dentist every 6 months, then the dental staff should be able to catch any formations of cavities and stop any further growth.

The best advice for those who are worried about cavities forming is to double down on strong oral habits. Make sure your children are brushing and flossing regularly. Monitor their diet and see if there are any areas that may have changed. For example, some kids can be receiving treats at school or from a friendly neighbor that can be full of sugar.

What Are My Options if My Child Has Cavities?

If your child has developed cavities, there are a number of different options that can be taken. Common options include:


As we mentioned above, if the cavity is small enough, the pediatric dentist may elect to allow the tooth to repair itself. This occurs because saliva can actually speed up healing processes. Saliva contains proteins, enzymes, and compounds that help harden the enamel of teeth and can even “remineralize” your tooth’s enamel. If a cavity is small enough, a tooth can go through remineralization (or self-repair) if oral hygiene and diet promote the saliva. If the diet is poor and filled with sugar and starch, it can and will overpower the saliva causing the cavity to grow larger. Your pediatric dentist in Alpharetta will discuss proper care and a course of action if they feel remineralization is possible.

White Fillings and Restoration:

If remineralization is not a viable option, a filling will need to be placed on the teeth. This process is commonly known to both adults and children. Your Alpharetta pediatric dentist will drill away at the cavity and decay. Once everything has been taken away, the tooth will be filled with a filling. At Polkadot, we use white fillings, which harden in seconds and mimic the color and appearance of natural teeth. For those who are worried, Dr. Nanna will walk through the procedure with the child, going over each tool that they would use.


If the tooth decay or cavity is large, a filling will not be able to do the job of restoring the tooth. A crown will create a protective structure around the afflicted tooth and will minimize the risk of developing a new cavity or further tooth decay on the tooth. To place a crown on a tooth, the tooth is shaved down, and then the prefabricated crown is fitted on the tooth, and then it is cemented on the tooth using dental cement. It’s important to make sure to use the right size for the crown as it will affect the child’s bite if the crown is too large or small.

Extractions or Baby Root Canals:

Once a cavity is so large that it starts to reach the nerve of a tooth, it will cause intense pain. The cavity can cause an infection and inflammation of the nerve, and when this occurs, the only option is to conduct a baby root canal. This involves the removal of the infected pulp (nerve and blood vessels). After removal, medication will be placed on top of the affected area. Unlike adult root canals, baby root canals are much different, they take only a few minutes to complete, and additional visits are unnecessary!

Laughing Gas or Nitrous Oxide:

Depending on the number of procedures or the comfort level of the child, laughing gas or nitrous oxide can be used. It is a safe sedative and extremely effective in helping children reduce anxiety. The laughing gas creates feelings of happiness and relaxation and has a rapid onset while non-allergic. The laughing gas is given by placing a fitted mask over the nose. Once the patient starts breathing through the mask, they will begin to feel the nitrous oxide. Laughing gas has no lingering effects and is perfectly safe. The use of this option will be at the recommendation of your pediatric dentist in Alpharetta, GA.

Sedation Dentistry:

In some extreme cases, the number or severity of dental treatments may be high. When it comes to dentistry for children, we have to balance the effectiveness of the procedure but also their overall comfort with dentists. Children can sometimes need extensive work, but the stress and discomfort of all the work create an anxious relationship where getting them to the dentist can be extremely difficult. Sedation dentistry is used to help balance the need for dental treatment while also ensuring a healthy relationship with the pediatric dentist on a long-term basis.

Help From a Roswell Pediatric Dentist

As stated above, tooth decay or cavities during childhood is a prevalent disease that significantly impacts a child’s life. ECC (early childhood cavities) is a chronic pediatric disease that, in today’s world, is more common than asthma, early-childhood obesity, and even childhood diabetes.

Childhood cavities can begin at any time in your child’s life, even when the first teeth emerge at around six months, so we have to keep in mind that when this happens, it will significantly affect your child’s early years.

There are many treatments available to prevent cavities in our children. Here we will find three essential preventive dental treatments for kids.

“Have you ever heard a dentist tell you not to clean your child’s pacifier off in your own mouth?” says Dr. Nanna.

“This is because the bacteria that live in your mouth can be introduced into your child’s. It’s also why we say never share toothbrushes or even store toothbrushes where they can touch each other. Introducing new bacteria can lead to decay, especially in a child who has a diet high in sugar and who doesn’t have proper oral care habits.”