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Dr. Andrew Rynne

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Does a decaying tooth in baby require medical attention?

Answered by
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Dr. Honey Arora

Dentist

Practicing since :2011

Answered : 12999 Questions

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Posted on Wed, 10 Oct 2018 in Dental Health
Question: My daughter(1.9 year old) who is still under breastfeeding has the upper front teeth decay. One of the tooth has even broken little bit because of the decay. Please refer the image attached for more information.

We had consulted our regular dentist couple of weeks back and he advised to apply salt water regularly and show her to a paediatric dentist this week. This process is very rapid and by the time we realised the damage was already done.

Questions:

1. How severe is this condition?
2. I am not sure how to treat this as she will not cooperate for filling or any other procedure in her mouth.

Please help.
doctor
Answered by Dr. Honey Arora 21 minutes later
Brief Answer:

Looks like Nursing bottle caries.

Detailed Answer:

Hi,

I have viewed the image and it looks like Nursing bottle caries.

If the decay already happens as we can see in case of your daughter then the early treatment has to be done.

This is necessary to prevent the deepening of decay which can make teeth painful by exposinng nerves.

It is not serious if treated on time and further preventive measures are taken like Fluoride application, wiping teeth with a wet clean cloth or cotton after ever feed.
Do not add sugar to milk if you give top feed.

The Pediatric dentists have certain techniques that help your child to cooperate for treatment.

So just don't worry, proceed for early treatment.

Hope I have answered your query. Let me know if I can assist you further.
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Honey Arora 24 minutes later
Thanks for the quick response.

Can she be treated without anaesthesia? I am worried about this because she may not cooperate for any treatment.
doctor
Answered by Dr. Honey Arora 6 hours later
Brief Answer:

Yes it is possible

Detailed Answer:

Hi,

Yes, treatment like filling and fluoride application can be done without anaesthesia.

In case if any extensive treatment like Pulpectomy is needed then local anaesthesia is needed.

Local anaesthesia can numb only the area of tooth being treated.

But first, a clinical examination and X-ray is needed to rule out the extent of decay and what treatment is exactly needed.

Hope I have answered your query. Let me know if I can assist you further.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Honey Arora 6 hours later
I have consulted 2 paediatric dentist today but unfortunately both have different opinion on the treatment plan.

1st dentist suggested fluoride application followed by composite crown for all four teeth.

I thought of taking second opinion with other doctor and the second dentist is not favouring crown at this age of 1.9 years. She suggested filling of all four teeth and see the progress and crown is recommended when she turns close to 3 as there can be chances of she swallowing it. But for the right most one she suggested doing X-Ray to see the extend of decay. She has also given an option of not doing X-Ray right now instead doing a filling and see the progress. If needed we can do the Pulpectomy incase it is needed in future. But she also mentioned that the tooth is little weak because of the decay and if the filling comes out then we need to redo the filling again. This doctor is also not favouring fluoride application as the decay level is beyond this application.

I went with the second doctor and did the filling of front 2 teeth today and will be doing remaining 2 tomorrow but still not sure whether this decision is right. I was reading about crowns and it says that it might stop further decay of teeth and also spreading of decay to other teeth.

Kindly advise if I am going in right direction or need to consider putting crown as well.
doctor
Answered by Dr. Honey Arora 12 hours later
Brief Answer:

You should have got an X-ray done first.

Detailed Answer:

Hi,

Well, the filling is the right decision but first, X-ray should have been done to see how deep is the decay.

But if now filling is done, it is fine and you can get the other teeth also filled.

Not only crown/ capping but properly done filling will also stop the further decay of teeth.

So now get other teeth also filled.

Hope I have answered your query. Let me know if I can assist you further.
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Honey Arora 2 hours later
Thanks for your feedback.

Few more questions:

1. Is it safe to do the X-Ray of her mouth as she is just 1.9 year old?

2. What can be the implications of doing filling without X-Ray?

3. Since couple of fillings are already done, is it still the better idea to take the X-Ray now?

4. Do we need to check the fluoride application after filling with our treating doctor to protect further decay of tooth and also to protect other normal tooth?

5. What is your opinion on composite crown? Can we put it after the filling to avoid further damage or we can wait for some more time for this?
doctor
Answered by Dr. Honey Arora 56 minutes later
Brief Answer:

Yes, go for filling.

Detailed Answer:

Hi,

-Yes, you can go for x ray, a single dental x ray does not cause and severe side effects.

-If x ray is taken the depth of decay is ruled out, so it can be decided firs hand that filling is to be done or pulpectomy.

-If there is no discomfort or pain in any tooth you can go for filling even without x ray, no problem in that.

-Yes, fluoride application can be done to protect other teeth from decay.

-You should go for filling or crown, but I would suggest filling as of now.

Hope I have answered your query. Let me know if I can assist you further.
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Honey Arora 18 hours later
Couple of other tooth are filled yesterday. Few more questions please.

1. I checked about the fluoride application with the doctor and she told she don't recommend it until kid turns 3 years. She is now 1.9 years old. Is this ok?

2. She advised to apply GC Tooth Mousse every day night when she is sleeping. Is this application has any side effects? Is it safe if the kid consume it for long tern as we are going to apply it daily.

3. There is one decay behind a behind a teeth which is already filled at front. Doctor told the filling may not remain there but will try that filling after a week after seeing how the other fillings are remaining in her tooth. Is this ok?

4. Do you advise complete weaning of breast feeding for this reason or can we still continue breast feeding her at day time till she turns 2 with wiping of tooth after every breast feeding.

5. How often do you think we need to do the followup of her. Doctor advised to have crown only after she turns 3 and decay should be managed like this till then. What is your opinion on this please?

doctor
Answered by Dr. Honey Arora 1 hour later
Brief Answer:

Yes, you can apply this paste at night.

Detailed Answer:

Hi,

-Yes, it is ok, you can wait for Fuoride application.

-Yes, GC Tooth Mousse can be applied at night as it will not cause any problem, small amount swallowed is not harmful but be cautious not to apply large amounts.
Better make her spit once or twice after 2-3 minutes of applying.

-Yes, it is ok, wait for a week and get it filled then.

-No, You can very much feed breast milk.

-Yes, I already told you that for now fillings should be done..

Hope I have answered your query. Let me know if I can assist you further.
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Honey Arora 10 hours later
Couple of more questions please.

1. Our doctor advised to apply GC Tooth Mousse at night everyday while she is sleeping. I am also worried about she consuming it. Even though they say it safe and all I am personally against all these chemical application. Please advise on the right time to apply it and how often we need to apply. Everyday application is absolutely needed?

2. We are planning to stop the breast milk at night as it is harming more than giving it at day time. Will making her drink water after breast feeing will help in removing the residuals in her mouth?
doctor
Answered by Dr. Honey Arora 12 hours later
Brief Answer:

No problem applying at night.

Detailed Answer:

Hi,

It you worry applying it after she sleeps then I would suggest you to apply it an hour before she sleeps and make her spit 2-3 times before she sleeps. It will be fine.

-You can simply wipe her teeth with wet cloth after feeding.
It is enough.

Hope I have answered your query.

Take care

Regards,
Dr Honey Arora, Dentist
Above answer was peer-reviewed by : Dr. Kampana
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