Obviously there is a vast array of answers from dentists out there...what one believes another vehemently disbelieves.
You will get to choose who to listen to, and what you want to do.
My guy was unfortunate enough to slam his little face down onto a table at 6 months, knocking out a brand new bottom front tooth. Since it had JUST come in (well, come in enough to be sitting tall in his gums, it wasn't just a nub of a tooth) it didn't save the space at all, and at 3.5 (today!) there's barely a gap. We are already figuring out what we're comfy doing when the time comes for permanent teeth but the room isn't there.
Possibly as an effect from that face-slamming, or possibly because crumbling teeth (sounds like a pregnancy nightmare, yes?) run in DH's family, two of his upper teeth came in brown, only a month or so later. Came in off color, grew a bit, turned brown. By the time a year (during which time we were actively looking for dentists with BRAINS in their heads...not always easy to do, especially when dealing with ped dentists!) had gone by, it was disintegrating, and JUST before we had our appointment with a decent, intelligent dentist, they had finally started to hurt him.
The brain-free dentist wanted to put DS under general in the office (ha ha ha ha, NO), would NOT let parents in (again, ha ha ha ha, what are you a pedophile? NO!), thought I was a wimp for leaving the room before he examined DS (we had figured out that DS responded differently when I was there, so to make it EASIER on the dentist I left DH, DS, and the dentist and sat out front), and was talking about pulling those teeth and probably the two middle front teeth b/c of a cavity on their back, and filling in every little bitty thing he could see. (all of that planned out without an x-ray, even!)
No!
The intelligent dentist filled the cavity behind the middle front teeth without ANY pain medication or laughing gas at all. DH was in the room, and DS sat on DH's lap, facing DH, then lay back with his head on the dentist's lap, rather than making him lay on a cold table. He did, however, get to watch Finding Nemo on the TV in the ceiling, which was a great anesthetic.
Next visit the dentist did use a tiny bit of lidocaine (but still no gas) to pull the two awful teeth (which were just nubs by that time). That time, only a week after the filling, DS *ran* back to the Nemo room and jumped up on the table, and was, I hear, happy as a clam to be there.
This dentist is happy to watch and see for the little spots, and ever since we got the buzzy Buzz toothbrush, those spots have faded for the most part.
And that's just two of the DDSs we saw. Opinions differ widely, but dentists don't seem to realize that and don't seem to admit it.
For us, there was absolutely no chance in Hades that we were putting him under, at 3, for fillings or extractions. And in the course of the appointments, we had figured out that he was whiny and clingy with ME, but a Brave, Big, Boy with DH, so we knew that DH would be with him, and he would NOT be alone with the staff. So we had to find someone who agreed with that, and had protocols in the office that matched the other things that were unacceptable (dentist and staff alone with child) and acceptable (series of things to try, starting with no anesthetic and working up as needed, to keep kiddo happy) to us.
Back in my childhood, there were plenty of kids with a brown or grey tooth in front. Nowadays it's a bit less acceptable...I know that while DS's teeth were changing color but not painful, I had a really hard time dealing with his teeth being that color, knowing the judgment that was being passed on us. And it really changed his appearance! Even if they hadn't disintegrated, I would have likely wanted to have them out...and especially for purely cosmetic reasons, General was NOT going to happen.
Decide what you're OK with, find dentists with protocols that match up with your wishes, and find out exactly what is going on with his tooth, and go from there.
