Dr. Staci Whitman explains that pediatric cavities can often be arrested or reversed without filling them, especially in older children whose teeth will fall out soon. Smooth-surface enamel lesions have a high chance of reversing naturally with a strong preventive routine, though younger children with years left may need more active treatment.
Usually we don't heal the cavity, we arrest it, which means it freezes in time, or we really slow the growth of it. And I'm okay with this in many pediatric patients because they are going to lose that tooth eventually. So I have to decide how much longer is this child going to have this tooth. If that child's 2 years old and they're gonna have the tooth for 10 more years, then I might be a little more proactive and say we can monitor it a little bit longer, but it's probably going to need a filling. If that child is 8, 9 years old and they're going to lose that tooth in a year, I often will watch it, but I tell you, if the cavity is in the enamel, it's a smooth surface lesion, you have a very high likelihood with commitment to arresting and reversing them.
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