Have you ever heard of a 7 year old needing a root canal?

Question

I am very strict with my children about brushing their teeth. But it appears that my 7 year old doesn't pay enough attention to his back teeth. He complained the other day about a toothache and so I got out the flashlight and inspected his mouth and realized he had a pretty good cavity going on in his last molar... you know, in the very back. I took him to the dentist today and the dentist says that he needs a root canal on that tooth. WHAT ?!?!? I have NEVER heard of a child getting a root canal. Has anyone else?

Answer 1

Well I'm not going to focus on the need for a root canal. Except to say sometimes a dentist will use the term Root Canal loosely if he does not want to confuse you when what he is really doing is a pulpal therapy on a baby tooth. The concept is the same, but the degree of difficulty for the procedure is totally different.

I see parents lay into their kids everyday. " See if you had listened you wouldn't have such a big cavity." Then they turn to me and expect me to continue their tirades. What most people don't know is that some people have teeth that erupt with defects, very deep pits, and very exposed fissures.

Some teeth are doomed before they even finish erupting into the mouth. And here is the kicker if I find one tooth with a deep cavity at the end of a very open fissure. usually all teeth develop similarly, so most teeth will be affected. Don't be too hard on your kid, because he probably will have more big cavities.

Answer 2

I'm a dentist.

The dentist posting above is somewhat incorrect. No dentist would perform root canals on deciduous teeth that have an adult tooth present to replace them in the future.

Generally, the adult first molars erupt around age 6. Adult teeth, upon eruption in to the mouth, have incompletely formed roots. In fact, roots are not completely formed until about two years after the tooth has erupted. Hence, at the age of 7, the roots of your child's adult molar may be open at the tip ("open" meaning that instead of having a tiny hole at the tip of the root, there is a very wide opening). The problem with having "open" or "blunderbuss" roots is that it is very difficult to adequately seal these roots closed when peforming a root canal.

This is where the treatment modification comes in, and it is purely a judgment call by the doctor. I'll try to go over this with you...

If the tooth is severely symptomatic, or the decay is so significant that cleaning it out results in a huge pulp exposure, or if the tooth is just plain necrotic, then the entire pulp system of the tooth must be removed. That means the pulp tissue in the "pulp chamber" of the tooth, as well as the pulp tissue in the actual roots of the tooth. Before sealing the tooth, however, a procedure called "apexification" may be elected by the dentist. In this procedure, the canals are filled with a calcium hydroxide material down to the tips of the roots. In two months, the calcium hydroxide is removed, and more is placed. Over time, this process stimulates the formation of what is known as a "calcific bridge" at the tip of the root, and thus turns an open root tip into a closed one that can be properly sealed by root canal therapy.

On the other hand, if the decay only results in a moderate exposure of the pulp (i.e. one that cannot be simply "pulp-capped"), and the pulp is clearly vital and not irriversibly inflamed, then a procedure referred to as a "pulpotomy" can be peformed. In this procecure, only the top part of the tooth's pulp is removed, and the pulp tissue in the roots of the teeth remain in place until "apexogenesis" takes place. The pulp tissue is responsible for producing the tooth structure, and that includes the roots. The idea is that leaving the pulp tissue in the roots allows continued development and proper completion of the roots...over a period of several months. Once apexogenesis has taken place (determined by x-ray), the tooth is re-opened and a proper root canal is performed.

Finally, keep in mind that neither of these procedures are always performed. If the root tips are only slightly opened, I find that I can nonetheless get a good seal and thus I will generally go ahead and do the root canal. It's up to the treating doctor.

On another note, your incredulity towards your doctor's clinical judgment is a bit disturbing.

Have you ever heard of the medical term "amaurosis fugax", a symptom where patients describe a blackening of their vision like blinds being lowered to cover a window? Never heard of it? Well, it exists (and when it happens, it means your squash is in danger).

Similarly, peforming root canals on children with grossly decayed teeth exists as well. Teeth do not come with instruction labels on them saying, "Attention Bacteria: Please do not colonize this tooth until age 20." If the tooth has decay that has affected the health of the nerve, then a root canal ultimately must be performed....with some modification of treatment as described above.

I can assure you that there are probably thousands of things in dentistry you have never heard of. Maybe I'm coming across as condescending, but you need to understand that just because you've never heard of it doesn't mean that it is questionable. Try to recognize the fact that you know next to nothing about this particular subject, and trust your doctor's decision.

Answer 3

Yes, root canals can be preformed on a 7 year old, but are unusual. It would be a VERY difficult root canal for the dentist to do, I'm assuming that they referred him to an endodontist (a specialist that only does root canals)? It is difficult to do, because the roots of the tooth have not fully formed at the age of 7. Besides doing the root canal, the dentist COULD extract this tooth & HOPE that the molar he will get around 12 will come into this spot (or close enough--he may need braces to help it move there). Please discuss with your dentist what would be the best option. Good luck.

Answer 4

The first adult molar appears in the mouth at 6 years of age. Now, if this is the tooth in which your child has a cavity, then he definetly needs an RCT but only if there is suffiecient root formation(which should be ok for a 7 yr old). If the cavity is in the deciduous molar, he will need an RCT if the cavity is large enough and the permanent tooth under it is still not ready to erupt. In such a case, a cavity in a primary tooth may result in damage to the tooth under it.
Make sure your dentist explains exactly why he wants to do the RCT, so that he is not doing it just for the sake of money. If you asked this to soothe your worries, be assured that its been done before!

Answer 5

Yes is it commen, it does happen, but it doesn't have to.

Children do not brush their teeth properly until at least 8 to 9 years of age. An adult still needs to brush their teeth until at least this age. You should also have a look at what your son is eating. You need to reduce the amount of sugar in his diet. Nobody has probably ever told you this, but they should have. Regular dental checks are also a must.

Being the last molar in his mouth it could be either his first adult molar or it could be his baby molar. Either way at 7 you need to save this tooth. If it is his baby molar this tooth is not supposed to be lost until around the age of 12 and if you have this baby tooth extracted then you run the risk of the adult molar behind it drifting forward and closing the space for the new tooth under the baby tooth that was supposed to erupt in that position. Crowding = Braces.

You really should talk to you dentist about this, why didn't you ask him?

Answer 6

I am an assistant at the best Endodontist office in our state, so we are told :) Very wonderful dr's. anyway. YES children can have root canals at 7, but it is not often. just recently i had an 8 year old patient. but the second dentist that responded is correct, the roots are not finished developing (even in that 8 year old) so it is very hard to properly do a root canal. I would recommend going to an endodontist, they are specialist and they if anyone would do it properly. more than likely use a material called MTA which allows the roots to finish forming even if they dont form perfectly "normal" shape. definately go to the endodontist and have them evaluate the tooth first though.

Answer 7

You obviously have insurance and the dentist sees a quick money grab. Get at least one more opinion from a dentist in a different town if possible.
I'm not an expert, but, aren't root canals done on wisdom teeth? 7 year olds don't have wisdom teeth yet??

Answer 8

Not until recently - but our trusted dentist has just told my 7 year old stepson that he will need a root canal done.
Apparently, the adult teeth are below the juvenile teeth, and can be significantly damaged if not properly taken care of in the early years.
So, while shocking, this is believable news.
I understand that it is quite unpleasant.

Answer 9

If he is 7 he will lose that tooth anyways, so why not just pull it. Don't let him get a root canal, they hurt bad. At least mine did then the tooth broke anyways, and they cost around 500.00. sounds like your dentist is looking for some quick cash. Get a second opinion or have him pull it.

Answer 10

I have heard of plenty of people with children that have had root canal's done. my son for one was one of them he had a cavity, it was taken care of by the dentist and by luck the filling fell out, didn't realize until he felt pain and by then the tooth was too far gone and they had to preform a root canal.....