DD(6) needs to have two baby first premolars out

[Anusername]

My daughter who just turned six have developed dental abscess for her two lower first premolars. We took her to see her dentist and she said they needed to be taken out, and referred us to Paediatric dentist as an emergency appointment. The Paediatric dentist saw her and also confirmed to take those out. We hoped that baby tooth root canals can save them due to concerns about permanent teeth alignment (loss of space, overcrowding, etc).

Since then, we have consulted another Paediatric dentist who can do root canals in the same practice, she also agreed to take them out. But I’m not 100% sure if she reaches this statement to avoid any contradiction to her colleague. I had expressed a very strong favor of keeping them during our consultation.

AIBU to consult another Paediatric dentist for this matter?

Am I crazy?

Yes.

If you think baby teeth are so important, why does your child have huge holes in them?

I’m amused by you posting dental papers. Your Google search doesn’t trump my dental degree (and 25 years experience!).

Please yourself, you’ll live longer! Good luck with finding a practitioner to do your bidding.

@Anusername - yeah, I think you are a little bit overthinking this, rather than crazy. I understand not wanting our children to suffer in the long run but if a root canal was a viable option for baby teeth, the dentist would have recommended it. They don't take removal of baby teeth lightly simply because adult teeth push them out as they come through. As it happens, my eldest had baby teeth removed due to poor enamel and cavities causing rotting and crumbling. We didn't get to the abscess stage as our dentist gave us a clear outline of treatment needed and what would happen if we delayed. They tried alternatives before we got to the removal stage after they didn't work. You're beyond that if they're recommending removal.

Jesus Christ. Three professionals have told you the teeth need to come out. You’ve googled and are now talking as if you are an orthodontist. I bet you were also an armchair Virologist during Covid, eh? Step away from the internet and listen to the experts.

For future reference Hall crowns are a great option if the decay isn’t too extensive. Once it progresses to the pulp then extraction is the best option.
Have you thought about your child in all this? An extraction is a much shorter procedure and under sedation should be relatively well tolerated.
Pulpectomy is a much longer more complex job, under rubber dam. It just isn’t worth it for a lower D.

I wouldn't be putting my child through the pain and trauma of a route canal on baby teeth. My younger was an early teeth lesser he was losing teeth naturally left right and centre from that age, that would have been a waste of time effort and pain for a child. I would be very surprised if you would find any dentist who would even be willing to do it.

I would just have them out, save her the pain. If she's predisposed to needing orthodontist work then nothing will change that and I doubt they will be able to tell yet at this age. We certainly couldn't tell which of our children would need braces at 6 years old. Maybe a specialised orthodontics could have predicted it but they couldn't have done anything about it at that point, we where constantly told with DD that we needed to wait for all her adult teeth to come through before anything could be done.

Hi OP. I had to have 10 baby teeth removed at 5 years old. I was absolutely fine, no trauma. Had braces aged 11-13 to correct a gap in the front that wasn't caused by the tooth removal. Absolutely fine now - I have great teeth

@HalfasleepChrisintheMorning thanks- I’ll keep it in mind that hall frame is an option. Yes she had her left lower baby molar 1 out already as none of the dentists said it can be saved. Shes fine with the procedure under gas and air. She’s due to have her right lower baby molar 1 out. But I’m thinking of trying root canal before we reach that stage. Taking a tooth out is easy anyway…

@CactusUmbrella thank you! It sounds like the impact (if any) from losing baby teeth for you is manageable. Do you remember if you lost primary molar 1 (which is the space holders for pre-molars)?

@minisoksmakehardwork for sure. I think the main reason is that the baby tooth root canal has low success rate over time. The advantage is that it holds the space for that period. If we got it out she might need a space holder, which needs to bond and can cause decays to the neighboring teeth(mainly worried about the first adult molar).

@@Anusername. Dentist here! She won’t get decay from any space maintaining appliances if her diet and oral hygiene are optimal

I’m sure I said Hall crown isn’t an option if the decay has reached the pulp which it sounds as though it has in these teeth.
FGS just accept that extraction is the best option!
You can have a space maintainer if you really want but they aren’t used much.
Your priorities need to be:
Removal of pain and infection - extraction of poor prognosis teeth
Sort out diet and fluorides to prevent any future decay
Treat any other decayed teeth so that future extractions are avoided
Orthodontic opinion in the late mixed dentition or early permanent dentition (age 11 would be ideal).

But you don’t seem very open to advice from actual dentists!

@Pinkypinkyplonk that’s very reassuring!

Completely agree

OP, I am a teacher with a safeguarding role. If a child in my school had suffered from rotting teeth and abscesses for over a month whilst her parent ignored the advice of 3 dental professionals I would be making a referral to social services.
What is happening here is your DD is being neglected. You are neglecting to follow advice from professionals, neglecting to manage your DDs pain. You’re disguising this neglect by claiming that you’re concerned about her future teeth. It’s akin to you not wanting her rupturing appendix out because it will leave a scar!
Just take her to the dentist and have the rotten tooth removed.

Absolutely not; you're not being unreasonable! It's completely understandable that you'd want to explore all options for your daughter's teeth. Losing baby teeth early can impact adult teeth alignment, and you're right to be proactive.

Here's some advice:
Reach out to a Third Pediatric Dentist

• A fresh perspective can be valuable. If possible, explain the situation and your desire to save the teeth.

Communicate Clearly with the New Dentist

• Be upfront that you've consulted two dentists and their recommendations.
• Express your concerns about space for permanent teeth and your interest in root canals.

Ask Specific Questions

• What are the success rates of root canals on these specific teeth in your experience?
• What are the long-term risks and benefits of each option (extraction vs. root canal)?

Consider a Second Opinion from the First Pediatric Dentist

• If there was good rapport, you could politely ask if they'd be open to discussing root canals again in light of your concerns.

Remember, You're the Advocate

• Ultimately, the decision is yours. Gather information, ask questions, and choose what feels best for your daughter's health.

Look for reviews mentioning successful baby root canals at the new practice. If cost is a concern, discuss payment options with each dentist's office. I know this can be stressful, but trust your instincts and keep advocating for your daughter's dental health.

@HalfasleepChrisintheMorning Thank you for your professional opinion! No I understand hall frame is NOT an option here but I’ve never heard it before so thanks for mentioning it! (just googled it and found this - seems very promising. https://www.nature.com/articles/sj.bdj.2017.273).

Do you think it is just wrong to let a endodontist to open her tooth and see if they can do root canal, if not straight away extraction? Would it be an easy judgement when you open the tooth?

But do you not realise the impact the level of infection as abscess produces and what that does to the gum and surrounding teeth. You are compromising the mouth hygiene of your child and causing long term damage by delaying. Plus antibiotics needed can cause possible long term effects on the emerging teeth. You're also assuming it'll be years before she loses those teeth, my youngest lost his at age 7/8 but of a tooth is not sound she's more likely to lose it sooner

A hall crown is not an option in your case as the tooth is infected.

The chance of success of a root canal on a heavily decayed baby tooth in a 6 year old is pretty much non existent.

The risks of removing it are crowding, which can be dealt with with orthodontic treatment.

The risks of keeping it are sepsis. Ffs get it extracted.

She may need braces anyway, many children have crowding regardless of early tooth loss. She won't have any problems eating

It’s a shame you’re not listening. The damage had been done with her previous diet and hygiene. Take the advice, learn and move on

@FiveTreeHill thank you! You said it’s nonexistent and may I know it’s a professional opinion pls?

@Pinkypinkyplonk may I also ask your professional opinion?

Do you think it is just wrong to let a endodontist to open her tooth and see if they can do root canal, if not straight away extraction? Would it be an easy judgement when you open the tooth?

If you go to a standard endodontist you’d need to check if they’d be able to provide what you are asking!! They have the kit for adult teeth and adult extractions/ surgery for the most part. And you’ve already been given paediatric advice

Endodontic treatment on deciduous teeth isn’t the same as on permanent ones. The materials used aren’t the same. It’s a procedure which is very rarely done

She has decay and gum issues at 6?!
Poor kid. Teach her to clean her teeth, monitor her. Do better.

@Pinkypinkyplonk yes you are right only a pediatric endodontist would know. But I suspect in some cases it’s not that obvious. The 2-year success rate is still not promising.