A dear college friend and fellow mom mentioned to me that she was having a conversation with another mom who posed the question that reflects the sentiment of this post’s title. This is an excellent question and is one that I answer very often. It’s true that baby teeth will eventually fall out. However, we have to keep in mind that prior to them falling out they are a part of the body. They have a nerve supply and a blood supply and everything is connected. However before I talk about physiology, I need to impress upon you the fact that dental decay is a disease. Yes, it is a disease. Its the most common disease of early childhood and is five times more common than asthma. I’m sure you’ve heard of strep throat. Well, dental decay is caused by a particular type of strep, not the same type that causes strep throat but it is bacterial in origin. Also, if your child’s oral cavity due to poor oral hygiene and diet is conducive to allowing these little strep buggers to cause cavities in the baby teeth, unless you modify the diet, hygiene and flora this will be the same oral environment that will be present when the permanent teeth start to erupt. And guess what? The best predictor of future cavities experience is past cavities experience.
Now that we’ve gotten that out of the way, let’s discuss the exfoliation of baby teeth or in other words when the baby teeth fall out. The top two front teeth fall out on average when your child is around seven to eight years old. The baby molars on the top or the bottom won’t fall out until your child at the very least, nine years old. Let’s think about this. If you bring your three, four or five year old child to the dentist because you notice a cavity that means the cavity is really large. If you can see a cavity with your naked eye, it will or has been causing your child pain or discomfort. If the dentist discovers it during the exam and then determines that the cavity isn’t small enough to remineralize and treatment is required, well….then treatment is required. If your child is three, four or five years old and cavities are discovered on the front teeth those teeth likely won’t fall out for a few years. If cavities are discovered on the back teeth depending on what tooth it is you shouldn’t expect your child to lose that tooth until at least nine or ten years old. Do you really want to leave disease in your child’s mouth for a few years? Additionally, enamel on baby teeth are much thinner than it is on permanent teeth so cavities get much bigger, much quicker on baby teeth. These cavities will likely cause pain and infection before they fall out.
This is called cellulitis. It is the result of an untreated dental infection. Cellulitis is very serious and has to be treated very aggressively. It happens because the bacteria spreads from the tooth into other spaces in the body.
Also, the permanent teeth are right behind the baby teeth. 
In addition to the pain and infection we previously discussed, bacteria from untreated decay on a baby tooth can travel up to the root and may also cause a white or brown spot or possibly a complete absence on a portion of the enamel of the permanent tooth. So yes, they are baby teeth and we want to take care of them. Lastly, and we’ll discuss this in another blog post but there is a direct correlation between severe decay of baby teeth in a child less than six years old and childhood obesity.
Warm regards,
Dr. Lezli
