How to treat cavities in 3-year-old children?

Written by Huang Kun Mei
Pediatrics
Updated on May 12, 2025
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If a three-year-old child has cavities, it is necessary to go to the pediatric dentistry department promptly for cavity removal treatment. Depending on the severity of the child's cavities, if it is severe, the child may need to have teeth extracted. If it is mild, the child will need to have fillings. It is important to pay attention to the dental care of the child. Make sure the child brushes their teeth morning and evening, rinses their mouth after meals, avoids drinking carbonated beverages, eats fresh vegetables and fruits, and drinks formula milk to enhance nutrition.

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Can a decayed tooth be extracted?

Whether a tooth with caries can be extracted depends on the extent of the decay. If the decay is shallow, it can be treated with a one-time filling. If the decay is deep, reaching the nerve, nerve-killing treatment is required, followed by anti-inflammation measures and, after inflammation control, root canal filling. In other words, teeth should be preserved through root canal treatment whenever possible and not extracted. If the caries has reached the deep layers of the tooth dentin, or is at risk of causing a perforation, such conditions are considered non-salvageable and the tooth should be promptly extracted. After extraction, timely dental prosthetics should be placed.

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Can cavities be seen with the naked eye?

Some cavities are visible to the naked eye, while others are not. Clinically, some cavities can be observed with the naked eye. Such cavities usually have damage that extends beyond the enamel, with obvious cavities and incomplete tooth structures visible. For example, cavities on the biting surfaces of molar teeth and on the adjacent surfaces of front teeth that are moderate to severe can be seen with the naked eye. However, not all cavities can be observed with the naked eye. When the decay is confined within the enamel without obvious cavity formation, it cannot be seen with the naked eye, but it can be diagnosed by taking dental X-rays. Clinically, there are also some cavities on adjacent surfaces where the decay starts from hidden parts of the tooth; some of these might show ink-soaked-like dark brown discoloration on the biting surfaces, but they too require dental X-rays for diagnosis.

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Dentistry
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How to perform pulp drainage for dental caries?

Pulpotomy and drainage for caries involve a treatment method for acute pulpitis or apical periodontitis caused by infected dental nerves. Teeth are composed of enamel, dentin, cementum, and pulp tissue. The pulp tissue, also known as the dental nerve, is located within the innermost part of the tooth, surrounded by the hard layers of dentin and cementum. Therefore, once the dental nerve becomes inflamed, the pressure within the pulp chamber rapidly increases. To alleviate the pain, it is necessary to release this pressure, namely by performing a pulpotomy and drainage. This can be done by drilling to remove some of the infected dental tissues, and then opening up the pulp chamber to relieve the pressure, significantly reducing the pain. If the dental nerve is completely purulent and necrotic, the top of the pulp chamber can be removed, followed by thorough pulpotomy and drainage.

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Written by Fang Xiao
Dentistry
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If the cavity doesn't hurt, does that mean it hasn't reached the nerve?

It is necessary to make judgments based on the patient's symptoms and examination results. Dental caries refers to the chronic, progressive, destructive disease occurring in the hard tissues of the teeth under the influence of various factors such as plaque bacteria. Whether dental caries is painless or has reached the nerve, the simplest clinical method is to judge based on the patient's symptoms, asking whether the patient experiences pain. In the early stages, there are only changes in the color and texture of the tooth, which do not cause pain. In the later stages of the disease, due to necrosis of the dental pulp, pain may not occur. At this time, diagnosis can be assisted by dental films; an X-ray can show the low-density shadow produced by the caries, and whether this low-density area significantly erodes into the dental pulp, which is also an auxiliary diagnostic method. Therefore, it is important to maintain oral hygiene, brush teeth morning and evening, and rinse mouth after meals.

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Will tooth decay recur after a filling?

Cavities are a type of chronic, progressive destructive disease caused by bacterial infection of the hard tissues of the teeth. Normally, a cavity should not recur after being filled, but each dental filling material has a certain degree of microleakage. If glass ionomer materials are used, the microleakage is somewhat larger, and after filling, there might be tiny gaps between the edge of the filling material and the tooth, where bacteria can continue to infect, also known as secondary caries, necessitating timely refilling of the tooth. If resin-based materials are used, the microleakage is relatively smaller, and the likelihood of recurrence after the filling is smaller.