The caption of this post may appear weird – no, it’s not as you would be convinced after reading this post.
We know that all the deciduous teeth (milk teeth) have an almost perfect time table (thanks to mother Nature – it is not in man’s control, otherwise we would have played havoc!) – of coming in the mouth and then falling off, medically called eruption and shedding (exfoliation) time.
These milk teeth fall because of the pressure from the permanent teeth developing under their roots — as the permanent tooth bud keeps on growing, it keeps on causing the destruction of the root(s) of the milk tooth lying above it. This natural process goes on till the milk tooth becomes so loose that the kid playfully takes it out with his finger and throws it on the roof just like a fairy tale. Now that is an ideal situation.
Many a times this ideal situation gets disturbed. To understand this, just have a look of the photograph of this 5year plus boy. You can see has caries on a number of teeth. His upper front teeth have already been restored (filled) as there were carious cavities.
Now, you see on the left side of this photograph, there are lying root pieces. These root pieces are of milk molar – there was carious cavity in this tooth which was neglected by parents for sometimes. With time, crown of the tooth just fell off leaving this root stump.
Now the question is –should this root piece be removed or not? ….For getting an answer to this question we need to know that the permanent tooth which would come at this place is yet 5-6 years away. So, if the root is not causing any trouble to the child, it is best left there as such as it maintains or ensures a proper space for the tooth developing underneath. Dentally speaking, we say even such broken root stumps act as Space Maintainer.
Now, what to do if the child has occasional pain in such root? – once in a while if pain is there, anything would work – some painkiller syrup that the kid normally takes or some pain-killer oral gel. Generally, I have seen in my almost 30years practice that such teeth just sit silently – and rarely if swelling is there, we need to give antibiotics also (Amoxycillin syrup /Capsules is mostly used and is highly effective — used it on lakhs of patients with great results!).
But if the swelling keeps on coming repeatedly which require repeated antibiotics, then we have to decide sometimes to take these roots out. Even otherwise, the decision to take out these roots is based on some important factors –age of the child, stage of development of the permanent tooth developing under it. Now, suppose these roots are seen in an older child say 9 years or older, there is no hesitation in taking these out.
One thing more – the tooth roots are lying in mouth and are not causing any pain but if they any sharp points or sharp areas, these are rounded off by a dentist so that they don’t pinch the cheeks or tongue or any other oral structure.
And last but not the least, for kids it is okay if we don’t remove the roots —they are rather jubiliant. Parents anxiety is required to allayed that just take it easy, it won’t lead to any problem rather it would ensure timely eruption of permanent teeth at right place avoiding expensive orthodontic care later on with braces. Even otherwise, child is coming to us for regular periodic check up every 6-month and if at any stage, we decide to remove these stumps – there is no problem. Cool!!
Patients are also made aware that keeping such root stumps in the mouth of the child would not in any way affect the development of the permanent tooth growing underneath. Guaranteed! —what else parents want from a dental professional.