The severity of tooth decay affecting your child’s tooth will influence the treatment options your paediatric dentist can provide.
Early decay preceding cavitations are called white spot lesions or demineralization. These areas of early decay can be treated with topical fluoride creams, some of which may turn the decay area black as they successfully stop the decay process (See info on Silver diamine fluoride)
Simple cavities can be treated with fillings or restorations. Tooth-coloured materials are mainly used today.
For deeper cavities that involve the tooth’s pulp or nerve, fillings alone may no longer be viable. Pulp treatment (also known as root canal treatment), followed by a crown to cover the broken-down tooth, will usually be offered, if the tooth is restorable. The silver-coloured stainless steel crown is the default material of choice for most practitioners due to its longevity and good success rates over the long term. Newer tooth-coloured crown materials like zirconia and bioflx crowns have also been made available these days, which cater to the aesthetic needs of some patients.
Finally, teeth that are severely decayed and cannot be saved would have to be extracted.
Both pulp treatment and extractions would require local anaesthesia. Depending on the child’s cooperation, different modalities would be offered. Normal chairside treatment can be carried out for the cooperative child requiring 1-2 visits of local anaesthesia. Dentally anxious patients may be offered sedation during treatment to help them cope. For very young patients or those unable to tolerate multiple rounds of local anaesthesia required, full dental rehabilitation under General Anaesthesia would be offered to the patient. Each of these modalities has its benefits and drawbacks – your paediatric dentist would be able to discuss them with you.
Article contributed by Dr Melissa Tan, dated 27 March 2025.