Does My Son Need a Pediatric Dentist or a Root Canal Specialist?

When my son was three, he took a tumble and bumped his face. He was upset and cut his lip, but his teeth looked fine, so I didn’t even consider taking him to the pediatric dentist back then. Here we are six months later and his tooth is turning an ugly gray color. At first, I thought it was just come kind of staining, but I have scrubbed at it to no avail and it looks like the whole thing is colored. I know in an adult this means the tooth is dead, but my son doesn’t seem bothered by it at all unless I’m messing with it. I think this must be connected to the fall, but I don’t understand why it would take so long to develop- he’s four now. I’m kicking myself for not taking him to the pediatric dentist back then. Could this have been prevented? Going forward, do I need to book him with a pediatric dentist, a root canal specialist, or should I just monitor for more symptoms? — Audrey

Dear Audrey,
It does sound like that tooth has died. When a tooth is injured, it can start to look like a bruise is developing from the inside. This may be from the fall he experienced earlier or from an unrelated incident. It’s not always easy to tell with small kids. Moreover, a dead or dying tooth doesn’t always cause pain. It just depends on what happened with the nerve. Taking him to the pediatric dentist right after the fall would not have prevented this from happening. The damage was instantaneous and even if it wasn’t killed right away, nothing could have stopped the progression.

At a certain point, baby teeth begin the process of resorption, in which the body starts diminishing the roots in order for the tooth to fall out. The pulp fades away naturally at this point anyway, and your son could be getting to that stage. With an adult, there’s concern over bacteria entering the chamber and creating an infection, which is why a root canal is necessary. The dentist cleans out the canal, and then fills the space so bacteria can’t seep in and cause a problem.

Given that your son will probably lose the tooth naturally in the next couple of years, you may not need to treat the tooth at all. It’s a good idea to keep an eye on it and if you’re worried about anything, you can have it checked out by the pediatric dentist.

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