If a child has a primary molar with permanent teeth underneath but showing signs of impaction, what should be done?

When a child has a primary molar with permanent teeth underneath that are showing signs of impaction, the recommended course of action typically involves extracting the primary molar and referring the child to an orthodontist. The reasoning behind this approach is that impacted permanent teeth can lead to a number of complications, including misalignment of adjacent teeth, prolonged eruption times, and potential for orthodontic issues later on.

By extracting the primary molar, space is created for the impacted permanent tooth to erupt properly. The referral to an orthodontist is crucial, as they can assess the situation further and devise a comprehensive plan to ensure optimal alignment and positioning of the permanent teeth as they come in. This proactive intervention helps prevent more severe dental issues in the future, which aligns with modern dental practices focused on early intervention and comprehensive patient care.

Maintaining the primary tooth or merely monitoring it may allow for the continued impaction of the permanent tooth, leading to further complications such as resorption of adjacent teeth or the development of cysts. Similarly, providing a filling and waiting for eruption does not address the underlying issue of the impacted tooth and may exacerbate the situation over time. Thus, taking immediate corrective action by extracting the primary molar is the most effective approach in this scenario