DR. KAYLA TOH: Can tooth decay in baby teeth affect permanent teeth?

An Dental

Picture of a kid holding on to a kid toothbrush

Baby teeth, or milk teeth, are the first set of teeth that children have by the time they reach 3 years old. These will subsequently fall off and be replaced by a second set of permanent teeth at the appropriate age. As a result, many parents often think that baby teeth aren’t important because they will be replaced anyway, and so there is no need to start dental care early. This is a huge misconception — let me explain why. 

What is the importance of baby teeth? 

Baby teeth, though temporary to some extent, play an important role in the transition into adult teeth, speech and function. The presence of baby teeth determines the amount of available space that the succedaneous permanent teeth may take up. This means that they hold the space until the adult teeth are ready to erupt and thereby help guide the latter into position, making sure they stay straight and even for a beautiful next set of teeth. 

If your child, unfortunately, loses his/her front teeth prematurely, it could potentially have some impact on their speech as they might be unable to enunciate or articulate clearly at the early stages of learning.

Several studies have shown that children who establish good oral hygiene habits early on in life are more likely to carry these positive habits into adulthood. This enables them to prevent dental problems throughout life, maintain healthy self-esteem and even have better performance at school. 

Simply put, baby teeth pave the way for permanent teeth - so don’t let them decay! 

What happens if you don’t fix cavities in baby teeth? 

Teeth are damaged by the presence of dental plaque which contains harmful decay-causing bacteria. Tooth decay can lead to cavities (dental caries) when enamel, the outermost layer of the teeth, starts to break down, leaving behind holes in the teeth. Decayed teeth are often roughened, blackened and unsightly, which may impact your child’s appearance and make them less confident. 

Aesthetics aside, cavities in baby teeth can result in the following problems: 

Oral health problems

Untreated cavities have the potential to lead to infection, resulting in significant pain and even emotional distress. Often, I find that this negatively impacts the child’s eating and sleeping habits as well as overall health; studies have also shown the link between childhood cavities, malnutrition and eating disorders. 

If you find your little one acting out more than usual or refusing to eat, it is possible he/she could be experiencing pain from tooth decay. 

Damage to permanent teeth

What starts out as an infection may progress into an abscess, a pus-filled “pimple”-like bubble, which can be very painful. On top of that, it may interfere with or worse still stop the development of the permanent tooth below, delay its eruption or even prevent it from erupting at all. Other possible problems that the succeeding permanent teeth may encounter are permanent discolouration and/or malformations. 

Orthodontic problems

If there is early loss of a baby tooth, orthodontic issues may arise. Neighbouring teeth may shift to fill the empty space, which could then pose a problem when it is time for the adult teeth to grow out. The permanent teeth in that area may be misaligned and/or crowded out if the space at the resulting area is insufficient, which can further cause the other teeth to become crooked too. In order to correct the alignment and bite of the permanent teeth, more costly treatments such as braces or Invisalign may be needed. 

Picture of a kid holding on to a tooth that fell off due to tooth decay

How do I look out for tooth decay in baby teeth? 

Common signs and symptoms of tooth decay in baby teeth include: 

  • Dark or brown spots on teeth
  • Holes in teeth, possibly with food debris stuck within
  • Pain pertaining to the teeth 
  • Swelling around the teeth
  • “Pimple”-like an abscess on the gum above the teeth
  • Bad breath

If you notice any of these signs and symptoms, or if your child is suddenly having problems eating and/or sleeping, visit a paediatric dentist straight away! 

How do I keep baby teeth healthy?

Make sure your child brushes his/her teeth well twice a day. I recommend using fluoridated toothpaste, but using the right fluoride toothpaste and the right amounts of it is crucial! Our previous article on whether fluoride toothpaste is safe for children can tell you more. 

Next, avoid consuming too many sweets and bring them to the dentist regularly for check-ups and routine cleaning. It is a common misconception that we should only see the dentist if there’s a problem, but we prefer to avoid doing this so we do not scare the little ones at each dental visit. I recommend regular dental visits from the age of 1 or when primary teeth start to erupt. 

Generally speaking, as long as your child maintains good oral hygiene and goes for scheduled dental visits, their baby teeth should be just fine!

Do you have a question for me regarding paediatric dentistry? Feel free to ask away, I am more than happy to answer them! 


  1. Mark, A. M. (2020). Helping your child fight tooth decay. The Journal of the American Dental Association, 151(2), 154.
  2. Zou, J., Meng, M., Law, C. S., Rao, Y., & Zhou, X. (2018). Common dental diseases in children and malocclusion. International journal of oral science, 10(1), 1-7.
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