The tooth is composed of enamel, cement, and pulp. The pulp includes nerves and blood vessels that provide the tooth oxygen and minerals. When the pulp is damaged or infected, root canal treatment is frequently done to try to save the tooth.
Children can lose baby teeth and even undeveloped permanent teeth when the pulp is infected. This is often happens as a result of trauma or tooth decay and generates a special issue to the child. The primary teeth serve as important guides for the developing permanent teeth that will take place of them.
For functional and cosmetic purposes, endodontic treatment is preferred to tooth extraction. It can maintain tooth’s, mandible’s and tongue’s function. It can also avoid speech problems, and atypical eruption of a permanent replacement tooth, or even losing a tooth that has no successor.
Endodontic treatment for baby teeth
Many aspects are different when handling with baby teeth instead of permanent teeth. Their durability is shorter, but while their forms, architecture and functioning are very much alike to permanent teeth, they also have differences. Endodontic treatment is affected by the resorption of the root, a normal action by which the roots of the baby teeth are absorbed by the body to permit for eruption of the following permanent teeth. This makes difficult the diagnosis and the suitable treatment.
Symptoms of pain frequently accompany the inflammation of the pulp. Nevertheless, major problems may occur without any experiences of pain. If possible, a differentiation should be established regarding either the pain is impulsive or only appears when stimulated; pain that disappears after removal of the cause is frequently fluctuating and suggestive of minor inflammatory variation. The stimuli that provoke pain include: thermal, cold and hot; chemical, caused by acidic foods, sweet or beverages; and mechanical irritation, wobbling a loose tooth or biting. Other usual causes include deep tooth caries, inaccurate fillings, pain around a baby tooth that is free to fall out, or a permanent tooth in eruption.
With flawless clinical techniques and some fairly extraordinary materials, a lot can be accomplished to save primary teeth. As regularly, treatment depends on diagnosis and assessment and, particularly in the case of baby teeth, it may be established by the condition of the tooth at the moment of examination.
Indirect pulp treatment functions best for teeth with profound decay nearing and/or almost revealing the pulp, where eliminating all the rotten parts of the tooth would reveal it. Alternatively, soft rotten tissue is removed as much as possible, leaving only harder remains without piercing into the pulp. Then using an antibacterial agent and reconstructing the tooth to seal it, prevents future infection. In this process, outer coatings of infected dentin are detached and a layer of filling cements is placed over the discovered dentin. By permitting inflammation to decrease, reparative/reactionary dentin is produced by the pulp to protect itself. Then a temporary filling is placed in the tooth to assure healing and comfort. After 10-12 weeks a permanent filling is placed. This procedure has proven 90% successful over three-year periods when it was properly applied.
Direct Pulp Capping is chose for “small accidental exposures of the pulp in the absence of decay.” The dentist will practically “cap” the exposed pulp directly using the materials mentioned above, to obtain a dentin “bridge” to close the exposure.
Pulpotomy is a “partial pulp elimination”, successful in 90% of cases. It is utilized to treat exposures of the pulp as a result of decay in baby teeth, when the infection/inflammation is restrained to the coronal part of the pulp. The technique includes elimination of the coronal part of the pulp, conserving the vitality of the surviving root areas of the pulp. Accomplishment is based on the dentist’s decision of whether the surviving pulp is healthy or inflamed. Efficient control of infection is very important; it includes complete elimination of inflamed pulp tissue, correct wound treatment, and efficient sealing of the tooth meantime and after treatment.
Pulpectomy includes complete eliminating of the entire infected pulp tissue. This procedure relates traditional endodontic treatment, with eradication of all the infected pulp tissue from the root canals; decontaminating, cleaning, sculpting and filling the root canals to seal them. The material used for sealing must be resorbable so that the body can resorb the roots normally, permitting the baby tooth to be lost and replaced by its permanent descendant.
Tips for Post-Treatment Care
Don’t eat anything until the anesthesia in your mouth wears off. This will restrain you from biting your tongue or cheek.
Do not bite or chew on the treated tooth till you have had it reestablished by your dentist.
Be sure to floss and brush your teeth as in a normal situation.
In case the opening in your tooth was reestablished with a momentary filling material, it’s not uncommon in-between appointments for a thin layer to wear off. However, if you believe the entire filling has come out, then you should contact your endodontist.
Immediately contact your endodontist if you develop any of the following:
a visible inflammation inside or outside of your mouth;
an allergic reaction to medication, including rash, itching or hives (nausea isn’t an allergic reaction);
