My four-year-old had his regular checkup with the pediatric dentist earlier this week and the doctor diagnosed two cavities. I didn’t know they were there before the visit, but once they were pointed out to me, I could kind of see them a little. They’re right in the middle of his two front teeth.

So, I don’t question that they’re there. The problem is, the dentist is recommending tooth-colored crowns as treatment. That seems a bit like overkill to me since the cavities are very, very small and these are his baby teeth.

To be clear, I want to do whatever’s best, but if this is overly aggressive treatment, I also don’t want to put him through all that. Right now, he does pretty well at the dentist and I’m worried having to have crowns done will be traumatic for him. I had a bad experience when I was little and am still afraid of the dentist to this day. I don’t want him to go through the same thing. Is it possible fillings are enough?

Thanks,

Geraldine

Dear Geraldine,

Sorry to hear you had a bad experience. Sometimes those things do stick with people and it’s more than understandable that you’re approaching this with some caution. You’ve asked some good questions too. Let’s break them down.

You Can’t Tell the Full Picture by Looking at the Outside of the Tooth

Sometimes cavities can be misleading. They may appear small on the surface, but still cause a lot of damage within the tooth. Your pediatric dentist probably took x-rays to aid him in the diagnosis. They give a better indication of what’s happening inside the tooth.

Crowns Might Be Warranted

Crowns are usually only done when the decay is extensive or the tooth has other issues and needs a “baby root canal,” otherwise known as a pulpotomy. Since you didn’t mention the latter, it sounds like the dentist believes the decay is extensive and the teeth will need extra support to stay intact.

Your son, under ordinary circumstances, would probably have those teeth for 2-3 more years, so protecting them is important. If they’re lost prematurely, his other teeth will start to shift to fill the gap, which often necessitates orthodontic treatment down the line. Sometimes kiddos develop issues speaking or with muscle development too.

Your Son Might Be a Candidate for Sedation

Oftentimes, doctors recommend sedation for children of this age when they need more intensive treatment. It helps ensure they stay still throughout the procedure and helps keep the appointment positive. Most kiddos sleep right through it and wake up in good spirits after with little memory of the procedure, itself. If your doctor didn’t mention this and you’re interested, ask him if it’s an option.

Talk to Another Pediatric Dentist if You’re Worried

Without a dentist looking at the x-rays and performing a visual exam, it’s impossible to say whether your son really needs those crowns or if a less invasive treatment will suffice. Moreover, it’s never a bad idea to get a second opinion if you’re unsure of a diagnosis. At the very least, it could help you move forward with treatment with greater confidence. Best of luck to you and your son.

This blog is sponsored by Dr. Raymond Bolt, an Auburn, AL dentist treating kids through adults.