Thank you for your detailed concern. Based on your description and X-ray findings, the right primary first molar is grossly decayed with only fragments remaining, and the second primary molar is also affected. In such cases, extraction is usually the most appropriate treatment for the decayed tooth, especially when the structure is not restorable and is causing pain.
We understand your concern about pain and your child's sensitivity, but modern dental extractions for children are performed under local anesthesia (or even conscious sedation, if needed), making the procedure painless and safe. Avoiding timely extraction may lead to persistent pain, infection, swelling, or harm to the developing permanent tooth underneath.
Next Steps
Go ahead with the extraction as advised by your pediatric dentist.
If the second molar is also decayed but restorable, a pulpectomy or pulpotomy can be considered depending on the extent of the decay.
A space maintainer may be recommended after extraction, depending on your child’s age and eruption stage of permanent teeth.
Health Tips
Delaying treatment could worsen the infection or affect the alignment of permanent teeth. Children tolerate such procedures well under the care of a pediatric dentist. Please stay assured that your child’s health and comfort will be prioritized.