dentist has left gaping hole. open in DS's tooth : normal ??

[bananacarnival]

Hello, please advise as I'm so confused and worried.

DS, 8, had a cavity when he was 5, our old dentist covered it up with a temporary filling which was topped up over the past few years. Last night he was in agony, our new dentist today said that there's an absess and she tried to temporarily take out the old barely there filling, suck out rotten food and put in new filling, but within an hour he was in agony.

Took him back this evening and was told that a temporary filling wont work anymore so he needs to have it all scraped out and left ' open '. Until it drops out aged around 11. I was horrified and asked about food getting stuck in this huge hole, which he said it will, so brush it out well..this is perfectly safe and normal, and far better than tooth extraction. DH has been googling yet everything we read suggests root canal !

Any advice at all? Im so confused.

I would have thought that you couldn't have root canal on baby tooth adult tooth will grow below.

You cannot put an 8yr old through a root canal and I doubt baby tooth enamel will sustain it. I think your dentist is right. if there's a big hole food will drop in and out. Fill it and the filling will clearly weaken and crack again and small bits of food will get in, you can't get them out and thus an infection will start.

that sounds awful! i would ask them to just do an extraction tbh!

It's called open drainage and is acceptable as a short term measure to allow an abscess to drain.

Following this he either needs a much simplified version of root canal treatment for baby teeth, called pulp treatment, or indeed, extraction.

My dentist puts in such a situation an extremely fragile and thin filling which he calls an eggshell overmthe top. If there is a lot ofmpressure due to the abcess you can then simply break the eggshell filling to relieve the pressure but you have tomgo back in for a clean and new eggshell covering. Maybe worth asking about?

Thanks all, this is all very useful and helpful. Northernlurker that's v reassuring..but Anniemouse the dentist is adamant it'll stay 'open ' for the next couple of years, and that's the bit that doesn't sound right to me. Long term open hole in a tooth?

Trouble is if you extract baby teeth, you often end up with needing braces as gaps close and adult teeth come through crowded. I'd go with the hole, sounds like tooth is dead already. Has abscess cleared?

I'm a dentist, I would extract personally although there is a valid argument for what your dentist is suggesting.

jchocchip is that actually true? i mean, surely your teeth will fit in your jaw (or not) regardless of whether you've had a baby tooth removed

Thankyou all, no idea if the abscess is still there or not. He says his gum feels lumpy

He also couldn't eat his breakfast this morning nor lunch, in floods of tears when food went into the 'hole'.

Happened to my ds after he had extractions of milk teeth

but maybe his teeth would have been overcrowded anyway?
I was under the impression that it's your jaw size/shape that affects how crowded your teeth are.

Be interested to hear some dentists opinions on it!!

There is an argument that primary teeth hold the spaces open and give guidance for the permanent teeth. However in this case where a child is in pain my primary concern would be to get them out of pain, not whether they may or may not require Ortho in future.

I would do a pulpotomy if possible, putting a medicament inside the place the nerve should be and then a filling over the top. I don't treat many children so AKiss is probably more current than me but it's better to keep the tooth for as long as possible if pain can be prevented.

I'm a dentist and would extract this tooth.
Mrsmorton, a pulpotomy is not possible as it is infected however a pulpectomy could be possible, ( like a root filling on baby teeth), but you would need an xray to determine amount of roots left to see if this was possible. Just leaving it will cause food trapping which would lead to bad smells not what I would want for my children.

Another dentist. I would want ideally to extract. My understanding is that once there is chronic pulp involvement in a baby tooth, rather than traumatic pulp exposure, pain outcomes are similar whether you fill or not. The best outcome will be gained via extraction. If ortho complications arise, so be it. The likelyhood of that is hard to predict, but depends on which tooth is affected and the child's age.

DD had a terrible cavity following a failed filling that dropped out and was fitted with a stainless steel crown which will come out when the tooth underneath naturally drops out. Would that be an option?

Thankyou once again for these replies. It's been valuable to read about experiences such as your daughter's herison, but also the viewpoints of the dentists.

Cant help but feel thoroughly upset at the prospect of having his tooth extracted.

Feel so angry with the school and their 'sweets for birthdays' policy, I used to find mysterious haribo wrappers under his bed when he was 5... Which is when it all began.