Must Choose Between Root Canal and Extraction for My Toddler's Front Teeth

Updated on January 20, 2015
L.Z. asks from Burbank, CA
24 answers

My 20 month old Toddler fell off and chipped both of her upper front tooth. When it happened one of the front tooth was chipped off, and you could see pulp. The other one was still in place but you could see the crack. I took her to a predicitc dentist and he did root canal on the broken one. My baby was due for her second visit one month later to complete its root canal. However, two weeks ago, the other cracked tooth fell off as well! and the pulp inside was already black. I took her to see a new pediatric dentist and she told me that it would need root canal as well. I didn't do it right away because my baby had fever and was sick. ( the reason why I saw a new dentist because the first one who did root canal was not patient enough to explain anything to me, and I felt like he should have caught the problem of the cracking tooth but he didn't, so I went to a new one instead). Today. I took her to see a highly recommended new dentist. She did X-ray and said the teeth were infected. First she suggested root canal on the second broken tooth and then on the next visit, she would do filling on both teeth. However, after she restudied the X-ray, she said that the root of the front teeth was not well developed yet, so the bottom of the root was not sealed. She said that in this case, root canal would likely cause infection in the future, so she suggested to extraction both front teeth instead! She asked me to make a decision as the gum is infected. So I have to make the decision in few days.

It is really a hard one, since I know if I lose them, then my baby will be without upper front teeth for a few years. she may have trouble bite or speak.

Any comments and suggestion will be welcome! Should I take risk of doing root canal and then wait and see. If they get infected later, then I could always have a choose of extract them. OR should I avoid more extra pain but do the extraction now?

Please help!

Thank you so much!
P.S.
Last night I took my child to see the second pediatric dentist again for her opinion. She saw the X-ray and said that the root of the untreated tooth was not even in the picture! She said that the treated tooth looked good. her opinion is that if you could save the baby teeth, you should. She did confirmed that there was an infection going on with the untreated tooth, so it needed to be treated. I just don't know which dentist to listen. :(

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So What Happened?

Dearest all,

Thank you very much for all your commends and supports! I couldn't be strong enough to go through all the stress without you there! I really appreciate every single mom for your kindest suggestion. It was a relief to see there were more kids out there had extraction when they were young. Well, with my daughter's situation. The untreated tooth got infected really bad. I didn't even noticed that until yesterday when a holistic pediatric dentist I consulted wanted to see a photo of the current teeth. When I went to take a photo, I was surprised to find out that her gum was swollen and bleeding! I took her to see the pediatric dentist whom we saw earlier and recommended for extraction. The tooth was filled out and the bleeding wasn't as bad as I expected. I think the whole extraction was so much simpler than the root canal. (after seeing both procedures done on my child) . I imagined my child to be in a lot of pain after extraction, but surprisedly after 5 hours of operation, she acted so much happier than before. Now I know she must felt a lot better and pain free. I am glad that I made the right decision. And I know I could not have done it confidently without all your support.

The same pediatric dentist suggested that I could either continue to complete the root canal on the other front tooth or pull it when my daughter recovers. She said since the root canal has already started and the area is not infected, maybe I could just finish it. Well. at least, I don't need to worry about the infection now and it will give me more time to think about it.

So here is the update for now. And I hope this information would be helpful to future moms who has similar situation. :)

All the best and warm regards,
L.

FINAL UPDATE
Yesterday, my baby had her second tooth extracted. I think it was the right decision to make. Although the dentist preferred to complete the root canal, but I didn't think it was worth the risk to have infection in her mouth and she's still too little to say anything. When we were at the dentist's office, she noticed that the gum of that dead tooth was infected. So my worry was right. And I am glad that we extracted the tooth!

My child acted so much more active only few hours after the extraction. And I can tell she seems so much happier. Now when I think about, I wish I could have pull those front teeth right after the accident. And that could save her a lot of pain. Thank you so much again for all the great moms here for supporting me. It is a big relief for us to see our child be pain-free! Thank you ALL!

Featured Answers

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J.C.

answers from New York on

Infection sounds scarier than no front teeth. I know lots of kids who went years without front teeth and they bite and speak fine.

3 moms found this helpful
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P.K.

answers from New York on

I would pull. You know root canal is not fun. I would not put my toddler thru it. But just my opinion.

3 moms found this helpful
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C.B.

answers from San Francisco on

My niece had all of her baby teeth pulled - she was without teeth for a couple of years and had absolutely no problems at all. She could eat anything and didn't have any issues with speaking.

I say let them pull them. Root canals are expensive, painful and they aren't worth the expense and pain, IMHO. The teeth are going to fall out anyway; no need to spend all that time and money and then to be anxious for the next couple of years looking for signs of infection.

2 moms found this helpful

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H.W.

answers from Portland on

Just to say: my girlfriend's nephew fell when he was about that age and knocked out his two front teeth. Just completely out. The dentist suggested not reimplanting them and so the space remained.... wanted to let you know that this bright boy still had no problem with speech or language development. Kids are resilient. Your boy will be okay.

9 moms found this helpful

V.S.

answers from Reading on

I had a friend whose son broke one of his central incisors as a toddler and had it pulled. For years, before his new one came in, it just looked like a kid who lost his tooth. Personally, I would avoid the trauma of a root canal on a toddler, but clearly you've done one, so you know what to expect. I would consult a speech therapist (as well as your dentist, of course) and ask whether this will cause permanent problems. With my friend's son, it did not, but he lost only one.

7 moms found this helpful

S.T.

answers from Washington DC on

i'd have 'em pulled.
khairete
S.

7 moms found this helpful

E.J.

answers from Chicago on

My kids take forever to get teeth and lose teeth.

My son 'bruised' his front baby teeth (age 5) and the permanents were no where to be found according to x-rays. The baby teeth stayed in place (discolored) but he bruised them again and got an infection in his gums. We waited a year for the stinking permanent teeth to come and in that time he had three infections set in bc there was a 'pocket of space' that developed between baby teeth and permanent teeth. It would've kept getting infected over and over until those baby teeth fell out. So we were set to have them extracted, but luckily they fell out in time. Phew.

In talking to the dentist, he said he had one girl that bc infected at least 2x per year and he had been treating this for 3 years now waiting for those permanent teeth to come in.

My point is what if you got the root canal done but your daughter developed a gum infection? All that time, money and pain for nothing? Would you want her to have all the antibiotics if this did happen? She is a toddler...what happens if she damages these teeth again? Keeping the teeth in place may lead to this happening to her.

I think I would go for the extraction and then see if spacers would be needed or appropriate.

5 moms found this helpful

L.A.

answers from Austin on

I did not realize baby teeth had roots.
I would pull them.
Make sure you are dealing with a pediatric dentist.

5 moms found this helpful
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S.H.

answers from Santa Barbara on

I know several families faced with this a noticed because the 2 front teeth were pulled.

They all seemed to be in a position to do either and they said the dentist gave them the choice (no guarantee the root canal would work) and the dentist seemed to lean towards extraction.

Ask the dentist if he/she has a two year old, what would she do?

Different boys I know have the adult teeth now and seem fine. Sure when they were 3-4 years old everyone would ask if they lost their teeth and the mom would explain the bike accident or just say there was an accident and it made more sense to pull them.

4 moms found this helpful
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K.O.

answers from Atlanta on

I would (and have) avoid the pain and do the extraction. It's likely the root canal won't even work and you'll end up with the extraction anyway. It's just kinder to the baby to pull the tooth. (My 3 year old is currently missing his top tooth because he face planted at Disney and cracked it badly). I thought the missing tooth would bother me, but after I got used to it, I don't even notice. However, if you feel the missing two will bother you, you can get a pedi-partial implant/denture thing. Chewing will be fine - kids (think 8 year olds) chew with the front 2 ( and sometimes all 4) missing. Chewing happens with the back teeth.

4 moms found this helpful

J.S.

answers from St. Louis on

My younger son was born with poor enamel so by two his molars were shot. We did have them all capped because you just can't eat without your molars and the adult molars don't start coming in until around age 7. If it had been his front teeth we would have considered having them pulled. Cosmetically it looks awful but they are only used to tear so they can get by without them.

So in your case I would probably go with pulling but perhaps talk to an orthodontist about getting a spacer so the gap is still there when the adult teeth start coming in.

4 moms found this helpful
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M.M.

answers from Boston on

I'd have them extracted and avoid the pain of a root canal and go ahead and treat the infection now. Talk to an orthodontist or pediatric dentist about a wre/spacer/appliance for a few years until the permanent teeth come in. When my son was about 5 and half/almost 6, he had 2 abcessed molars. The oral surgeon we were originally referred to gave me the "choice" of a pulpectomy or an extraction. We went for a second opinion (after to talking to our family dentist) we went to our local pediatric dentist, who recommended an extraction and did the appliance and advised us to spare him the pain of the pulectomy. His teeth are now fine and really don't know how much it affected his speech since he already had artic issues to begin with but his speech therapist was made aware and she worked with him.
Good luck

4 moms found this helpful
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S.W.

answers from Amarillo on

I would get the infection cleared up and pull the teeth.

My grandson had an issue with teeth and they were pulled at about your son's age. So for a few years there were no teeth. He now has a mouth full of teeth that are healthy. The last time I saw him (Thanksgiving) he had braces so that they were perfectly straight for the future.

People do not think "what happened to that kid's teeth?" when they are little. They are kids that had something going on and they are missing a tooth or two because of it.

Remember baby teeth fall out so the adult teeth can come in.

the other S.

4 moms found this helpful
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J.K.

answers from Wausau on

Given the info you shared it sounds like he needs an extraction and a course of antibiotics. I wouldn't even wait a few days if you can get him in now.

It's not that I'm against a root canal in general - they are not the big deal people tend to inflate in their minds - but your son's teeth and gums are already infected, so that ship has sailed. I'm not even sure why the dentist let you think it would be an option at this point.

4 moms found this helpful
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J.F.

answers from Las Vegas on

So sorry this happened to your little girl. That's a lot of dental work for a little person to have to deal with!

Anyway, I would not mess around with infection in the mouth, head, or face area. Seems a second root canal would just be more pain with no guarantee it would work or be infection-free.

This is a difficult situation, but I think I'd have to go with the extraction.

Wishing you and your little girl the best with this.

J. F.

3 moms found this helpful
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B.P.

answers from Cleveland on

If have them pulled it would be much better in the long run for her health.

3 moms found this helpful
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C.S.

answers from Las Vegas on

From what you describe, the extraction is the way to go, based on the dentists findings in the end.

I wouldn't worry about a few missing teeth if it means you will not be fighting an infection. Infections are painful.

My daughter fell and I thought for sure the teeth chipped, but they actually went inside the gums. The ER doctor said they were up there, even thought they appeared broken to me. He said they would come down in a few weeks to months and they did. She was toothless for a little while. She was 13 months, so we didn't have much to worry about in regard to speech. As for your daughters speech, I think you already know in advance that a speech therapist is in order.

*I don't know why someone is asking why you have seen 3 separate dentists, I think you explained yourself well.*

2 moms found this helpful
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D.N.

answers from Chicago on

My son is 3. His 2 front teeth have decay. The dentist did see him and we have to have him put out due to his medical condition and age. She told me there was an option of root canal but aid it was not worth the strain on him as well as other issues that come op When he goes for his treatment, if they can ,they will save the teeth. But it the root is affected, then they will pull them out.
I have a niece that had her front teeth pulled when she was 3 1/2. She was fine for the years she had no front teeth. No problem eating and while she did have a slight lisp without them, she talks fine now.

2 moms found this helpful
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D.C.

answers from Los Angeles on

My so was born with hydrocephalus went through surgeries upon surgeries so to comfort him and do the best possible I bottlefed and he ended up with horrible bottle mouth. He had to have surgery to extract all his baby teeth by 2 1/2 years old. The funny thing is he went through so much but always such a happy smiling baby. Anyway the moral to this story is that the docs had to extract all my kid's teeth except the molars. He is now 10 years old and with a bit of help with a speech therapist, he is perfectly fine and his teeth have all grown in.

2 moms found this helpful

M.D.

answers from Washington DC on

My 7 year old had 4 cavities, two that required crowns. I asked the pediatric dentist why we can't just pull them since his new ones should be in shortly and he said if the new ones didn't come in, the space could close and other issues would arise from there not being a tooth there.

I honestly don't know what I would do, and I'm sorry you are going through this - and your little one!

1 mom found this helpful
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C.P.

answers from San Francisco on

I'm so sorry! Wow that's terrible. Get another opinion... Maybe many opinions. My daughter at 18 months old did something similar. And we didn't treat it right away and it caused infection and tooth decay. We ended up getting a bunch of pediactric dentists opinions (5) and went with a root canal and porcalin crowns. It seriously was expensive and I debated just extracting them. However I'm very pleased with the result. My daughter is now 3.5 years old and the teeth look natural and work perfect. If it happens again at this age I think I would extract. At your daughters age however, if you can afford it I would try to save the teeth!!! Its important for her speech development and self image. :(
I'm so sorry again. Like I said when I was there it felt like a lose lose situation, and it is. :(

1 mom found this helpful
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G.B.

answers from Oklahoma City on

It sounds like you need to find one dentist and take your child every 6 months. I know there have been some emergencies in this case but the pulp in that tooth was black. That should have been caught on a regular dental visit when they did X-rays.....

In this case I don't know what I would do. The new dentist isn't wrong. If the teeth are so badly damaged then they do need to come out. That's not a huge deal since that just means her front adult teeth will come in without much of a struggle since nothing will be in their way.

If there is any way to save them I might do that too but only if your insurance would pay the majority of it. Putting her to sleep and getting the work done is best for her so she won't have to go through that awake.

Figure out which dentist you are going to stay with. This new one might not be all that great and the other ones might be great. You didn't give the first one the chance to check their work. Drilling a root canal isn't exact. He might have had a valid reason for not going all the way to the end. I can't imagine why but perhaps the infection she has now has stretched the tissue around the end and it's exposing more tooth?

I don't know but one thing I will say again, please make sure you take this child to the dentist you choose every few months for a while to make sure the infection is gone and to make sure other teeth didn't get too infected and are dying too.

It sounds like your child's teeth might have weak enamel and might need extra care from their dentist.

1 mom found this helpful
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M.H.

answers from Dallas on

Why have you gone to three separate dentists? Considering this last one was waffling between root canal and extraction, I would get a second opinion with a different dentist (a pediatric dentist).

If you do, I would also ask for copies of the X-rays so you don't have to get new films done.

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