The myth, in one line
"They're just baby teeth — they fall out anyway." It's the most common thing we hear from parents whose child has a cavity. It sounds reasonable. It's also one of the biggest contributors to preventable childhood dental problems in Australia.
Here's the part most parents never hear: that cavity you're tempted to ignore because it'll "fall out anyway" is often still there 6 years later, now painful, infected, or affecting the adult tooth growing underneath it. But there's good news — the modern treatment is gentler than almost every parent expects.
The silver tooth — the gentlest fix in paediatric dentistry
For baby molars with decay, the gold-standard option is the stainless steel crown — the "silver tooth" you sometimes see on kids. It covers the entire tooth, seals in the decay, stops it progressing, and stays put until the baby tooth naturally falls out. Multiple randomised controlled trials show they outperform fillings for long-term success on baby molars.
The part that surprises every parent: in almost every case, a stainless steel crown on a baby tooth does not require a local anaesthetic — no needle, no numbing, no drilling.
The modern approach (called the Hall Technique) seals the crown directly over the decay, sealing it off from bacteria and sugar so it stops progressing. It's backed by published evidence, including multiple randomised controlled trials.
At Berala Dental, we have never needed to use local anaesthetic to place one. Most kids sit through the whole thing quite happily — often surprised it's already done.
Why it's the preferred option
- No needle, no drill — the biggest source of dental anxiety in kids is removed entirely
- One short visit — most are done in 15-20 minutes
- Lasts the life of the baby tooth — falls out naturally when the baby tooth does
- Stops the decay — the crown seals the cavity off from bacteria, halting progression and often allowing the tooth's inner layer to self-repair
- Backed by evidence — a well-established technique in paediatric dentistry since 2006, with strong research support
Why baby teeth deserve this care in the first place
Parents reasonably ask: if baby teeth fall out anyway, why bother fixing them at all? Three reasons.
1. Baby teeth last longer than you think
The timeline surprises everyone:
- Front teeth fall out around age 6-7
- Canines around 10-12
- Back molars — the cavity-prone ones — don't fall out until ages 10-12
So when a 4-year-old has a cavity in a molar, that tooth has 6-8 more years of chewing ahead of it — longer than most kids' entire primary school journey.
2. They cause pain and infection if ignored
Baby teeth have larger nerves relative to their size than adult teeth. A cavity that would be mildly sensitive in an adult can be agonising in a child — and it progresses faster because the enamel is thinner. Untreated cavities become abscesses, which become emergency visits. Dental caries is consistently reported by the Australian Institute of Health and Welfare as one of the leading causes of preventable hospital admissions for Australian children.
3. They affect the adult tooth forming underneath
Each baby tooth is succeeded by an adult tooth forming directly beneath it. When a baby tooth infection spreads, it can disrupt the enamel formation of the adult tooth — a clinical condition called Turner's tooth. The adult tooth can come through discoloured, pitted, or with defects that need lifelong dental work.
4. They hold the space for adult teeth
If a baby molar is extracted early, the surrounding teeth drift into the gap. By the time the adult tooth tries to come through, there's no room — resulting in crowding, crooked teeth, and often an orthodontic bill later that dwarfs whatever was "saved" by not fixing the cavity in the first place.
Other treatment options — when a silver crown isn't the answer
Silver crowns are ideal for baby molars with small-to-moderate decay. When a tooth is different, we have other options:
White spot (very early decay) — remineralise
If caught at the chalky white-spot stage, decay can often be reversed without any filling at all. High-fluoride toothpaste, professional fluoride varnish, and some diet changes are usually enough to rebuild the enamel. This is why early check-ups matter — by the time a cavity is visibly dark, this window has closed.
Front teeth or small cavities — a filling
For front teeth (where appearance matters) and small cavities, a tooth-coloured composite filling is usually the best choice. Takes 15-20 minutes and does require local anaesthetic.
Very deep decay — extraction + space maintainer
If a cavity has gone right into the tooth's nerve and can't be saved, we'll extract it and place a small appliance called a space maintainer to hold the gap until the adult tooth is ready to come through. Not ideal, but sometimes necessary.
How to prevent the cavities in the first place
The three things that matter most, in order:
- Stop putting sugary drinks in bottles/sippy cups. This is cavity cause #1 in under-5s. Juice, flavoured milk, sweetened formula — all the same damage.
- Brush twice a day with fluoride toothpaste. Smear (rice-grain size) for under-3s, pea-size for 3+. You brush for them until age 7-8. They can't do it properly before then — anyone who tells you otherwise hasn't supervised a 5-year-old brushing.
- Get fissure sealants on the adult molars as soon as they come in (around age 6). Covered by Medicare CDBS. Prevents the most common cavity site in kids entirely.
If you want a proper assessment of your child's teeth — including early white-spot lesions that are still reversible — book a kids' check-up. Most kids are fully bulk-billed under CDBS, so cost isn't a barrier. The appointment is 20 minutes and it tells you exactly where you stand.