Primary tooth management
Balance symptoms, restorability, exfoliation timing and cooperation. Use prevention, restoration, pulp treatment or extraction when appropriate.
Understand
Primary molars maintain function and space but their prognosis depends on symptoms, root resorption, infection and the permanent successor. Extraction can have orthodontic consequences.
Assess
Check vitality signs, furcation changes, restorability, cooperation and exfoliation timing. Differentiate a symptom-free deep lesion from an abscessed tooth.
Apply
Choose prevention, restoration, pulp care or extraction in the whole-mouth plan. Discuss whether space maintenance is relevant after early loss and coordinate with carers.
Key distinctions
The primary dentition has thinner hard tissue and different pulp anatomy, so lesions can reach the pulp quickly. Root resorption and the permanent successor affect prognosis and extraction planning. A restorative choice should consider child cooperation, isolation, remaining lifespan of the tooth and ability to follow up, not only the size of the cavity.
Think through a case
A heavily decayed primary molar has a furcation radiolucency and a permanent successor beneath it. A vital pulp procedure is unlikely to address established infection.
The distinction to remember
Do not treat a primary molar as expendable without considering space, function, pain and the successor.
Test your recall
Why does the primary molar's successor matter?
Show answer
Its development and eruption affect treatment planning.