Should a baby's decayed front teeth be filled?

Written by Tong Peng
Pediatrics
Updated on April 06, 2025
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Children's front teeth cavities require filling treatment, because if the front teeth are extensively damaged, it not only affects eating and appearance but also impacts the child's psychological development. Therefore, if a child's tooth color is abnormal, it is advisable to visit a hospital for fluoride treatment as soon as possible, which is beneficial for mineralization on the tooth surface.

However, if cavities have developed in the front teeth, filling treatment is needed, otherwise it will progressively worsen, affecting the child's normal eating habits. Generally, children under three years of age have poor cooperation and cannot undergo routine outpatient treatment, so it is crucial to strengthen oral hygiene care in daily life.

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How to prevent cavities in children

Prevention of tooth decay in children should first encourage them to develop good tooth-brushing habits, reducing bacteria and plaque on the tooth surface, and include brushing in the morning and evening, as well as rinsing after meals. Enamel is the hardest substance in the human body but is susceptible to cracking. Acidic or sugary substances are harmful to teeth, so it's best to avoid sweets and acidic foods in the evening and to brush teeth before going to bed. Brushing teeth before sleeping is crucial and some anti-cavity treatments should be done, such as fluoride application or dental sealants. It's also important to develop a habit of regular dental check-ups to detect and treat cavities early.

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Can you ignore a cavity if it doesn't hurt?

When patients develop dental caries, it is recommended that they visit a formal medical institution for treatment. If the tooth decay is not addressed, it may worsen significantly. While it may not always cause pain, the teeth can still be damaged. Over time, the teeth might deteriorate severely, potentially leaving only the roots. This could also lead to damage to the tooth roots, causing inconvenience in the patient's dietary life and might lead to severe complications later on, including pain and irritation to the gum tissue. Therefore, it is advised that patients seek early medical treatment and undergo appropriate therapeutic measures based on the condition of their dental caries.

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Written by Li Bao Hua
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Will tooth decay recur after a filling?

Cavities are a type of chronic, progressive destructive disease caused by bacterial infection of the hard tissues of the teeth. Normally, a cavity should not recur after being filled, but each dental filling material has a certain degree of microleakage. If glass ionomer materials are used, the microleakage is somewhat larger, and after filling, there might be tiny gaps between the edge of the filling material and the tooth, where bacteria can continue to infect, also known as secondary caries, necessitating timely refilling of the tooth. If resin-based materials are used, the microleakage is relatively smaller, and the likelihood of recurrence after the filling is smaller.

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If the cavity doesn't hurt, does that mean it hasn't reached the nerve?

It is necessary to make judgments based on the patient's symptoms and examination results. Dental caries refers to the chronic, progressive, destructive disease occurring in the hard tissues of the teeth under the influence of various factors such as plaque bacteria. Whether dental caries is painless or has reached the nerve, the simplest clinical method is to judge based on the patient's symptoms, asking whether the patient experiences pain. In the early stages, there are only changes in the color and texture of the tooth, which do not cause pain. In the later stages of the disease, due to necrosis of the dental pulp, pain may not occur. At this time, diagnosis can be assisted by dental films; an X-ray can show the low-density shadow produced by the caries, and whether this low-density area significantly erodes into the dental pulp, which is also an auxiliary diagnostic method. Therefore, it is important to maintain oral hygiene, brush teeth morning and evening, and rinse mouth after meals.

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Cavities that do not hurt still require root canal treatment.

Cavities that do not hurt may or may not require root canal treatment, depending on the extent of the decay. If the cavity has not reached the dental nerves, there will not be noticeable pain. In such cases, since the decay is relatively superficial, direct filling, or dental restoration can be performed without the need for root canal treatment. If the cavity is severe and has reached the dental nerves, causing the nerves to become necrotic and purulent, there will be no pain due to the loss of sensory function from nerve death. In these situations, root canal treatment is needed. This involves removing the infected dental nerves, followed by medicinal treatment of the root canal, and after the inflammation is controlled, filling of the root canal is performed. In other words, a painless cavity might actually be caused by necrosis and pus formation in the dental nerves, requiring root canal treatment.