The Case for Saving Teeth in Children

A child over the age of six gets into an accident, maybe hit by a baseball, falls off a bike, gets in a car accident.  He or she is hit in the mouth. The front teeth are broken, seemingly broken beyond repair. The recommendation is made to have the teeth removed. They can be replaced with dental implants once the child reaches adult age. 

Is that entirely true?  It actually isn’t the entire story. When a tooth is extracted, the bone that supported the tooth loses its shape as well. The gum and bone shrink, often to the point where grafting will be necessary as an adult before an implant can be done.  

How can the child be managed so that the need for grafting as an adult is reduced? The answer is to retain the tooth until the patient is ready to have the implant placed. Let’s assume that a tooth is broken to the gum line. We’re talking about a permanent tooth. It can’t be restored. But it can be saved with a root canal. The tooth is ground down to the gum line, removing any sharp edges. Then a removable partial denture is constructed over the broken tooth or teeth. The root stays in the mouth, preserving the bone and gum tissue. When the child is of adult age, the root is then removed and an implant immediately placed. No need for grafting. And a natural esthetic result.

So before you allow that extraction to take place, get an opinion from an endodontist and a periodontist. Together, they may be able to help your child or grandchild avoid a bigger problem later on. 

Lee N. Sheldon, DMD