The importance of the primary dentition to children - Part 2: Effects of treating carious teeth by extraction

The short-term consequences of dental caries in primary teeth include pain and infection. Early management of carious lesions in children can prevent such sequelae, lessen the trauma to parents, save costs and time and to provide better quality of oral health. An important function of the primary teeth is to maintain the natural dental arch and to allow the permanent teeth to erupt in an orderly fashion with adequate space. If carious lesions are not treated early, extraction will be the only treatment option, which in turn, depending on the age may have adverse effects on the developing permanent dentition. Children with severe dental caries usually require the extraction of several and, on occasions, all primary teeth. Premature loss of primary teeth by extraction will influence the occlusal relationship and space in the permanent dentition. Children like to have a set of teeth similar to those of their peers and thus avoid ridicule and criticism. Any criticism directed at a child's missing, or unsightly teeth may be traumatic to his/her psychological development. Therefore, carious primary teeth should not be left untreated until extraction becomes the only treatment option. Several restorative approaches and materials are available to restore the primary teeth. However, restorative management of carious teeth is only the first phase of treatment and its success lies in maintaining a favourable oral environment. Therefore, treatment should be definitive yet specific for each individual child, with long term follow-ups and reinforcement of preventive measures.