Baby teeth fall out, but pediatric dental care is still critical

Dr. Contreras uses a model to instruct a patient sitting in the dental chair.
Claudia I. Contreras, DDS, uses a model of teeth and gums to educate a patient.


Good dental hygiene starts early in life and its benefits extend beyond clean teeth and fresh breath. In fact, a consistent schedule of daily brushing, flossing and twice-a-year visits to a dentist can lead to better overall physical and cognitive health as well as higher self-esteem.

Claudia I. Contreras, DDS,

“There is a perception by some that because baby teeth fall out anyway, why treat them,” said pediatric dentist Claudia I. Contreras, DDS, who is also an assistant professor at The University of Texas Health Science Center at San Antonio School of Dentistry. “This thinking is harmful because hygiene habits start in childhood. Learning proper manners, hand washing, bathing and brushing teeth all start in childhood — washing between your toes is as synonymous as flossing between your teeth.”

In its last Texas Oral Health Basic Screening Survey, the Texas Department of Health Services reported that nearly 53% of kindergarteners and 67% of third-graders in Texas had experienced tooth decay. It’s these statistics that motivate Contreras to dispel misconceptions about dentistry for children and increase access to treatment. She said there is often painful and lifelong consequences for children whose teeth go untreated.

Oral health and physical development

Maintaining good oral health is crucial for a child’s physical and social development. It directly affects proper speech, eating and smiling, all of which contribute to social acceptance.

Teeth play a crucial role in enabling children to articulate sounds effectively while speaking. Certain sounds, such as ‘F’ and ‘S,’ are particularly influenced by the presence or absence of teeth, often causing challenges for some children. Many children begin combining words around their first birthday, which is when most dentists recommend they have their first dental visit.

A toddler resting her head on the table refusing to eat her food.The tongue and back molars are vital instruments for eating and nutrition. When working well together, a child can push food around the mouth, breaking it down for easy swallowing. If dental discomfort disrupts this process, a child may struggle to chew properly or restrict the types of food they eat, potentially leading to nutritional deficiencies over time.

The ability to speak clearly and eat properly is associated with a child’s ability to socially interact, forming the foundation for effective communication and positive relationships. A healthy smile also boosts confidence and contributes to a child’s overall well-being. It promotes a positive self-image and social acceptance.

Oral health and cognitive health

The pain, discomfort and embarrassment that often accompany dental diseases, including cavities, can negatively impact cognitive development and self-esteem, affecting daily life.

A child sitting in a classroom with his head in his hands.Cognitive development, the process of learning and acquiring knowledge, may be disrupted if dental pain or infection leads to missed school days. Research indicates that children are three times more likely to miss school and four times more likely to have a lower grade point average due to dental-related pain than any other illness.

Dental discomfort hinders a child’s ability to concentrate. Persistent or increasing tooth pain resulting in missed school, creates a cycle of missed educational opportunities that negatively affects academic performance.

The consequences of poor school performance extend beyond academics, potentially causing feelings of shame or inadequacy in children. It can also negatively influence social acceptance and contribute to lowered self-esteem.

“Cavities can turn into infections, infections into abscesses, abscesses into something even more serious, such as cellulitis. These are real consequences of untreated teeth. It’s hard for parents to see their children in pain, so it’s important to prevent it,” Contreras said.

Compassion in dentistry

Contreras practices what she teaches to her students.

“We’re not here to punish or point the finger at patients or parents of children experiencing dental issues,” she said.  “Dentists, especially pediatric dentists, are meant to find new ways to inspire their patients to better care for their oral health. I teach my students that it is not our job to be accusatory but to give positive feedback, to tell our patients what they are doing well and encourage that.”

A family poses for a photo outside in with their bicycles.
Left to right: Kevin Hakala, Ashling, her brother Tommi and mother Yun Shi.

Yun Shi and Kevin Hakala experienced this firsthand after entrusting Contreras with their daughter Ashling’s dental care after she injured a tooth at the age of two. Five years later, Ashling has a healthy, permanent one growing in its place.

“We have been taking Ashling at least twice a year to see Dr. C for checkups,” Shi said “She had quite a few cavities when she was five that required treatment, but Dr. C helped identify some changes in her teeth and we are all paying more attention at home. Dr. C answers all our questions. She also uses each opportunity to educate us parents about oral health.”

In describing his daughter’s comfort level at the dentist’s office, Hakala said, “Ashling will often bring a drawing or colored picture for Dr. C when she goes for a visit. They have a great relationship.”

Ashling was quick to confirm that.

“She has been so sweet to me. She makes me so happy and she always makes my teeth clean …she is the best dentist I have ever seen in the world,” Ashling said.

“Patients who come in for an appointment after missing many years or those coming in for the first time can expect compassion and understanding from their dentists, not judgment,” Contreras said. “We are here to work with families and teach them the habits that will prevent future problems.”

Contreras stressed the importance of making parents aware of the many affordable pediatric dental clinics in San Antonio and South Texas, including:

For help scheduling your child’s next dental appointment, call UT Dentistry at 210-450-3500.

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