Milk teeth are going to fall off anyway, right?

Dec 6th, 2018
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It is one of the biggest myths in dentistry that baby teeth or deciduous teeth do not matter since they are going to fall of anyway. This blog is to bust that myth and provide a reality check.

Growing up is the most essential phase of a child’s life. General Heath and Nutrition play a very indispensable role in growth and development. Then what gives the negligent parent the right to not prioritize this part of Health - that related to the oral cavity. It is a vicious circle of plain ignorance and lack of awareness which the parents are often entangled in that leads to this catastrophe. And to their rescue there jumps in the Miracle Worker - the Pediatric Dentist or the General Dentist working with pediatric patients! His or her job is not as easy as you feel - in fact it’s a rather cumbersome one. The Miracle Worker not only has to miraculously treat the child patient with the fairy wand - using the no tears formula ;) but before that most emphatically convince the child patient's parent of the importance of the deciduous teeth, making him aware of the graveness of the problem and its effect on the succedaneous dentition.

Today's parents are half-google scholars. Before their visit to the dentist the parent would have already made a list of --- how-to, what-for, only if required --- queries spread over various categories. Hence, today's well-read, educated parent needs a scientific rationale and will not comply if not provided a logical explanation.

So how does the Pediatric Dentist or the General Dentist working with pediatric patients convince the parent.

Imagine a scenario when a 3 year old child walks into the dental clinic with his parent for dental advice and questions.... Aren't they baby teeth? Why are they important? Why do we need to save them?
So here is a sample explanation given by the clinician to such a literate parent.

"The oral cavity is one of the deepest crevices of the body that houses numerous micro-organisms and if left unclean and unhygienic can cause a series of problems. It is the only passage route for healthy, hygienic food to enter the oesophagus (food pipe) and further on the intestines from where nutrition is provided to the entire body. So imagine that a child is fed an extremely nutritious morsel of food into his mouth only to realise that ‘the very nutritious food’ gets mixed with the oral salivary fluid that is full of obnoxious micro-organisms, leftover food fibres stuck behind & between the molars producing a bad odour due to the overnight fermentation, plaque and sometimes calculus, decay on certain surfaces, may be a purulent exudate emanating from the gums – such a mouth is far away from being a healthy one - afflicted with the most chronic childhood disease, Early Childhood Caries.

These happenings when repeated every now and then will only result in Compromised General Health. Hence it becomes extremely mandatory for the parent of the child to ensure that the oral cavity is kept clean and healthy. Children require their oral cavity – teeth, tongue, gums etc. to eat, to chew or masticate, to speak or communicate, to learn, to sing, to play an instrument and most importantly, to smile.

The smile on a toddler’s face is the epitome of the happiness he bears within. Any embarrassment in the form of a decayed tooth, chipped tooth, missing tooth may cause deterred confidence levels as the child grows.

The young budding years contribute to the phonetic development of the child. Vowels like s, t, d, require the contact of the tongue with the teeth which in turn is responsible for speech development. Missing teeth may hamper the acquiring of communication skills.

The shape and alignment of the arches is extremely important for the facial profile development. Any premature loss of teeth or habit development like thumb sucking can cause deformity in the arches which may have a direct or indirect effect on the profile.

Hence, one needs to safeguard baby teeth or milk teeth or deciduous teeth in order to prevent these damages."

When the clinician counsels the parent patiently emphasizing on all the aforementioned information, it is clear to the parent that milk teeth need to be saved and for very important reasons.

Once this explanation is provided and the parent is convinced, it’s usually time for the Round 2 of questions as it has been noted as per experience parents do not give up their anxiety so easily......
When will they fall? Aren’t they supposed to fall around the child’s 5th or 6th birthday?

As a Dental Graduate Student, each one of us mugged up that table which stated the age of eruption and shedding because it was a part of rote learning. When asked on a practical basis with application most of us would go wrong. Let’s follow a small trick that would help us answer the patient's parent in a jiffy and calm down the frenzy. Let us learn the numbers so that they are at the tip of our tongue and also help us make practical, logical, ethical decisions.


Eruption of Permanent Teeth in a Simplified Manner for Practical Purposes

This chart would not only be so helpful in memorizing and understanding but also enlighten the clinician to take rational decisions regarding the treatment modality.
For the scenario of the 3 year old child, if a mandibular second deciduous molar needs a pulpectomy is it justified? Yes, it is because when we do the math 10/12 years – 3 years = 7/9 years. So, basically the child patient needs his second deciduous molar for a period of 7 to 9 years to fulfill requirements mentioned above and hence should not be extracted or subjected to any temporary restorative treatment.

So, that is the end of this blog. Let us forge in to the era of taking the right initiatives especially when it concerns the health of our future generation. A decision made for them today will affect the tomorrow.

Please Note: The above representation of ‘Eruption of Permanent Teeth in a Simplified Manner for Practical Purposes’ belongs to Dr. Akshata Prabhu-Puranik and cannot be used without permission.

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