Treatment of pulpitis of milk teeth in children is phased. What methods are used to treat pulpitis of milk teeth? Signs of a very serious tooth injury

By its nature is severe inflammation hard tissues inside and outside the bone. Usually pulpitis develops as a complication of advanced caries. In some cases, the disease develops on its own, but this happens only after a serious maxillofacial injury. Inflammation develops in different ways - chronic or acute. But today we are interested in how this disease is tolerated by a milk tooth and how to treat it.

Information about the disease

It is important to note the factors that contribute to the development of the disease:

1. The tooth is exposed to toxins released by microbes in carious cavity affected incisors;
2. Serious injuries that provoke children's pulpitis. These include, and careless processing of teeth by doctors, opening of nerves;
3. An infectious disease that causes a child to lose stable state immunity;
4. Incorrect choice filling material, which does not fit the type of bone. Dairy requires special tools and materials, in addition, some may experience pathological allergies;
5. Overheating of tissues oral cavity during the preparation of caries without cooling with water or air.

Pulpitis temporary teeth develops quite often, usually at the age of about 2 years. The disease of the molars, which grow closer to the throat, appears at the age of 3 years and until they change to permanent ones.

According to statistics, treatment of indigenous children is required five times more often than canines and incisors. Also, cutters mandible are affected more often and faster than the upper.

Now consider what the classification of pulpitis in children looks like:

• Spicy. It is also divided into purulent and serous, which also draws into inflammation The lymph nodes;
• Chronic. It is subdivided into fibrous, hypertrophic and gangrenous;
• Exacerbation of pathology in a chronic form.

Chronic

Such a classification can also be given by the doctor who will examine the child, so it is better to familiarize yourself with it right away.

The manifestation of the disease, the first sign

Pulpitis of milk teeth in children, no matter how strange it may seem, develops much faster than its full-fledged counterpart. Therefore, he quickly flies through most of the standard stages and singles them out to a person without medical education difficult. We will consider in detail how children's pulpitis develops and how pulpitis is treated in children.

Pulpitis in children is somewhat different from the usual, here are the main factors:

• The disease can develop in the oral cavity, even if caries is minimal there;
• Lightning spread;
• If you do not start treatment of pulpitis of milk teeth immediately, then after a short period of time the disease will develop into a chronic form;
• Chaotic symptoms, signs depend on the stage and the specific case;
• Children show an atypical reaction of the body to the disease (fever, drowsiness, pain, etc.).

How does acute pulpitis behave?

In an acute form, they always begin to manifest themselves with painful sensations. As a rule, it occurs abruptly and unexpectedly, usually in evening time. Also, the pain is aggravated by the use of too cold or hot food. on the bone or getting into the carious cavity of food. Acute pathology necessarily affects the lymph nodes - they become inflamed and increase in size.

Usually pulpitis. permanent teeth with unformed roots originates in the oral cavity with severely affected teeth, and if the bone is severely destroyed, then this is considered an exacerbation chronic disease. In some cases, pulpitis generates purulent pockets due to which it is significant. In this case, the pain increases significantly, and the child is unlikely to be able to accurately indicate which incisor fell ill first, because every bone in his mouth will hurt him.

Chronic form

This type of pulpitis development is somewhat different from acute and may even develop without any symptoms. Accompanied by the slow development of pathology, which ends with the complete destruction of the incisors. Often the disease is associated with inflammation of the soft tissues near the tooth. Treatment of teeth with immature roots in children does not differ from acute form, but it takes more time. The main sign of the appearance and development is pain, which manifests itself only under the influence of a powerful stimulus.

Pulpitis therapy

Started in a timely manner in a large number of cases makes it possible to keep the teeth intact. The basic principle followed by doctors is to remove the inflamed tissue, clean internal cavity bones. In terms of dairy in children, it is difficult, since the dentist can only cut out those tissues that he sees and he cannot touch unformed roots, because then a permanent incisor may not grow. If the coronal part of the incisor is affected, but not the root, then you can remove the completely affected part along with the crown, it will not get worse.

In good clinics it is possible to treat pulpitis baby tooth in one visit, but it is necessary to do anesthesia, which means that the child must adequately tolerate injections in the gum. If the child allows to prick him, then the doctor, having kept within one procedure, will immediately clear the oral cavity of the pathology. Treatment of teeth with unformed roots does not end there; after physical cleaning, the doctor leaves a special antiseptic preparation on the root, which is needed to disinfect healthy tissues and prevent their infection. In this way, it is possible to localize the disease and prevent the development of complications.

Depending on how it goes postoperative period the drug is either replaced with a new one or removed. Some doctors still stick to the practice of putting arsenic in the cavity to kill the sensitivity of the bone, and after a few days completely clean the tooth. Such therapy is allowed, but it is necessary to strictly observe the stages of treatment of pulpitis of milk teeth in children, otherwise arsenic will corrode the tissues and the tooth will only suffer even more. Too powerful concentration of arsenic will also only hurt, so the doctor needs to be extremely careful in his actions.

In some cases, due to an error, the dentist could not save the tooth, this happens if the roots that have not yet formed are damaged by a drill or toxins from drugs. Therefore, before starting the procedure, the doctor should warn the child's parents about the consequences of treating pulpitis of permanent teeth with unformed roots. And parents will already decide whether to take such a risk or use a conservative method of therapy. Regardless of this, it can be said that rather than sitting and deciding to treat or remove the pulpitis of a milk tooth, it is better to always monitor the condition of the child’s oral cavity, remind him of regular cleaning and occasionally consult a dentist. Examinations at the dentist will help to avoid pulpitis and a host of other dental problems.

Diseases of milk teeth in children harmless problem contrary to most parents. Without proper treatment, they lead to violations of the formation and growth of molars. Pulpitis in children is the most common disease resulting from specific features structures of children's teeth. Next, we will consider how pulpitis manifests itself, why it occurs, what forms it has and how to treat small patients.

The soft tissue located inside the tooth, with many nerves and blood vessels, is called the pulp. As a result of any impact annoying factors its tissue becomes inflamed and the patient develops pulpitis. The most common factors of childhood pulpitis are pathogenic microorganisms(staphylococci, streptococci), penetrating directly deep into the tooth due to the presence of a carious cavity.

The localization of the disease in the mouth can be different, but in most cases the disease affects lower teeth and molars. Anterior teeth are less commonly affected. Running pulpitis threatens with complications, such as periodontitis or periostitis. In childhood, such complications progress much faster than in adults, even in a day. There are cases when, in just a couple of days of the development of an acute form of pulpitis, a child began to become infected with blood, ending in death. An important task of parents is to detect and cure caries in their babies in time.

The reasons

Milk teeth are more prone to the occurrence of an illness than molars, and the special structure of temporary teeth is to blame. Their enamel is thinner, the dentin is not strong, and the pulp chamber is wider. The dentinal tubules of milk teeth are wide and short, as a result of which the inflammatory process spreads rapidly. immune protection child's body is not fully formed, which prevents him from fighting the infection as effectively as an adult, the result is that infectious and inflammatory diseases are so common in childhood.

Factors that increase the risk:

• the presence of caries;
• trauma to the tooth enamel;
• frequent infectious diseases;
• chemical or thermal effects on the teeth;
• unintentionally exposed nerve as a result of dental procedures.

In 85%, the disease occurs due to caries, when the enamel is affected, later the infection passes to the dentin and penetrates directly into the pulp.

Photo

Kinds

Pulpitis in a child can manifest itself in acute and chronic form. The first type is diagnosed less frequently, but its symptoms are much more severe.

Spicy

1. Serous stage. The channels are filling up serous fluid the pulp becomes inflamed. The first pain often comes at night, during the day it is manifested by temporary attacks during chewing. After 5 hours, the next stage begins.
2. Purulent stage. It is characterized by the formation and accumulation of pus in the channels. If the child has strong immunity, then unpleasant sensations may not occur, and pus will come out through the cavity destroyed by caries. But most often purulent acute pulpitis manifests itself prolonged pain. The child cannot say exactly where it hurts, because the pain is given to nearby teeth. Lymph nodes and body temperature may increase. Most parents take their kids to the dentist.

Chronic

Sometimes chronic pulpitis appears as a complication of the acute form, but most often occurs as an isolated disease. The manifestation of chronic pulpitis in children can be of three types. Exacerbations of the disease are isolated as a separate form.

1. gangrenous inflammation can be recognized by the absence of sharp pain immediately after taking hot or cold food, after a while there is a pulling toothache. With this form of pulpitis, the child appears bad smell from the mouth, sometimes the baby feels heaviness or fullness in the area of ​​the affected tooth. There may be swelling and inflammation of the periodontium.
2. Chronic fibrous pulpitis, like gangrenous, is the primary stage of the disease. It is detected on examination by a dentist and is characterized by the presence of a carious cavity and softening of the dentin of the tooth. After cold or hot food pain disappear as abruptly as they appear. This type of pulpitis sometimes goes away without visible signs, and parents seek help only when the process is already at an advanced stage.
3. Hypertrophic view the disease is characterized by the growth of the pulp, the existing crowns are often destroyed, pain occurs when chewing food.

Transfer from healthy tooth to periodontitis

Symptoms

Sometimes pulpitis is asymptomatic. In such cases, regular visits to the dentist will help to detect the disease in time. But most often, the following signals indicate the presence of problems in the oral cavity:

• temperature rise;
• inflamed tissues around the tooth;
• painful reaction to hot or cold food;
• putrid smell from the mouth;
• inflammation of the lymph nodes;
• puffiness.

Symptoms of the disease may occur separately or appear together. In any case, you should immediately show the child to the doctor.

Diagnostics

After contacting pediatric dentist the child must undergo a series of mandatory procedures in order to assess the condition of the oral cavity and choose a strategy for the process of therapeutic measures.

Do not delay with a trip to the doctor and examination

1. A general survey of parents and the child about when the pains began, how severe they are, what is the frequency of occurrence.
2. Examination of the mouth, facial contours and lymph nodes.
3. Directed dental diagnostics. The condition and thickness of dentin, gums, the reaction of teeth to irritants, the severity of edema (if any) are assessed.
4. If necessary, the child is sent for an X-ray of the tooth, EDI.

After complete diagnosis the baby is prescribed appropriate treatment.

Treatment

The choice of method of therapy is influenced by the age of the child, his individual characteristics, the state of the root canals, as well as the nature of the pulp damage. Distinguish between traditional and modern methods treatment of pulpitis in children, which differ not only in the materials used, but also in the technique of execution.

In any case, the goal of the dentist is to avoid the extraction of milk teeth as much as possible, but sometimes it is still required.

Traditional Methods

In ordinary children's clinics, you will most likely be offered a method of devital amputation. It involves work in several stages.

1. During the first visit, the doctor applies an arsenic-free devitalizing paste to the opened “nerve”, which must be worn for about 7 days. Or a paste containing arsenic. Then the exposure time is reduced to 2 - 2.5 days.
2. After the pulp and its contents are destroyed by the paste, a resorcinol-formalin mixture is injected into the canals of the tooth. The hole is treated with a paste that mummifies it, preventing it from rotting and decomposing. You may have to visit several times.
3. During the last visit, a permanent filling is placed.

It should be noted that it is impossible to heal a tooth treated with paste, because over time it creates a kind of “plug” in the channels. Removing such a tooth can be very problematic.

The process of treating the disease: drilling, root canal cleaning, filling

Modern approach

If the roots of the teeth are sufficiently formed and the child can withstand prolonged manipulations, then it is recommended to use a devital or vital extirpation. Such methods involve 2-3 visits to the dentist.

The difference lies in the first stage of preparation. During vital extirpation, the canals are immediately released from the nerve, and the devital procedure begins with the installation of a devitalizing paste on the opened pulp. She gradually kills the nerve. Next on standard scheme mechanical cleaning of the channels is carried out, their drug treatment. next step the damaged pulp is removed, and the paste is placed in the sterile canal. Use zinc eugenol paste or foreign analogues. hallmark pastes used in the work of such methods is the possibility of their resorption along with the roots when the teeth are changed to molars.

Another effective modern way, allowing to cure pulpitis of the tooth - vital pulpotomy. Its task is to leave the entire contents of the tooth, or at least part of it, in a viable state. top the nerve is partially removed, and the root pulp is treated with a special medicine. "Pulpodent" and "Pulpotek" are widely used, they are practically non-toxic, relieve pain during and after the procedure, keep the tooth viable, preventing re-infection.

Treatment of unformed roots

When a baby cuts temporary teeth, the top of their roots remains open for some time. The described condition of milk teeth is called unformed. Extirpation methods with canal treatment and complete removal of the pulp are not suitable here. Pediatric dentists have two more options at their disposal.

• Biological. Such treatment is considered conservative and requires accuracy and attentiveness from the specialist, since the slightest misses with antiseptics will lead to repeated pains. In addition, he has enough contraindications.

The biological method of treatment involves the preservation of the viability of the pulp. Thus, it continues to supply the tissues of the tooth with nutrients. Pain is blocked by anesthesia, the carious cavity is cleaned of infected tissues, and the opening or bottom of the cavity is treated medical paste. After a few days, the pain subsides, and a filling is placed on the tooth.

• Amputation. One of the most popular in dental practice. How pulpitis is treated with this method is clear from its name. The method involves the removal of the affected pulp from the teeth. Almost all drugs can be used for manipulations: from resorcinol-formalin to Pulpotek or Pulpodent.

It must be understood that with a devital amputation, the pulp is completely killed. In addition, strong toxic pastes can be used. Over time, after such manipulations, the tooth begins to crumble and break off.

Errors and consequences

Due to the fragile psyche and unconscious resistance, kids often interfere with the dentist to carry out the procedure in accordance with all the rules. Fear of visiting a doctor, the unknown and painful sensations are perceived by the child as torture, not help. Restless children do devital amputation with resorcinol-formalin (allows you to somehow cure the tooth).

Often children get a burn on the gum due to the paste getting there. As a result of such mistakes, the pain intensifies, the child is sent for an appointment again, the work is carried out again, wound healing gels are prescribed.

The treatment of children who have not yet formed roots is characterized by the risk of bleeding due to the efforts made by the doctor during the cleaning of the channels. The needle injures the tissues, and it is quite difficult to stop bleeding, even using hemostatic drugs.

Inexperienced dentists sometimes face such a problem as breaking off part of a dental instrument in the canal or root perforation. threatens serious inflammation fabrics. In such cases, the part that remains in the canal is removed, and a special material is used to close the perforation. If the doctor does not have the necessary equipment at his disposal, then most often with the help of drugs they simply mummify the canal.

Training

To minimize the risk of negative consequences after treatment, the child must be prepared in advance. Ideally, at the first visit, the doctor will not perform any interventions, but simply conduct a preliminary examination and allow the baby to adapt to the situation.

Tasks of parents before visiting a pediatric dentist:

• tell the child that bad teeth can be cured, and the pain will pass.
• explain that they are waiting for the usual procedure, all children and adults go to the doctor to treat their teeth if they start to hurt;
• in no case do not intimidate the child and do not tell horror stories about doctors;
• do not deceive the baby that there will be no pain. It is better to say: “Yes, it will be unpleasant, but after treatment your teeth will stop hurting”;
• to keep calm, first of all, to the parents themselves;
• you can show in a playful way how manipulations are carried out, let the child do them himself with family members;
• bring your favorite toy. If the baby wants, let him hold it in his hands;
• choose a time when the child feels well, slept and ate;
• if the baby flatly refuses and a tantrum begins - do not force it, it is better to reschedule the session for another day.

There are times when children are initially very scared, worried and naughty. In such situations, you can give the baby a permitted sedative drug and visit the dentist in 20-30 minutes. If the child is too restless, the doctor may recommend that the procedure be performed under general anesthesia.

Prevention

Prevention of pulpitis lies in the timely treatment of caries. It is necessary to regularly conduct dental examinations, because, for example, chronic fibrous pulpitis (without external signs) can only be detected by a specialist.

In addition, so that caries does not occur on the teeth of your child, his body needs all the minerals necessary for teeth. Limit your use sweet food, give only water at bedtime and teach your child to brush their teeth daily.

Pediatric dentistry is a separate medical field, where the professionalism of a doctor must be combined with knowledge of the psychology of babies. All dental diseases are curable, the main thing is to little patient allowed to perform the manipulations correctly. Milk teeth are always treated, because pulling them out is dangerous for the formation of the correct bite.

The first thing to do is get your child used to regular dental checkups. The earlier the better. The baby will not only be familiar with the situation of the treatment room, but will also become aware of why he came here. Often, kids run away from the reception in a panic, because they associate it with a kind of execution. In this case, persuade him to come again - a big problem. Parents, tell your kids positive sides treatment, tell me, the dentist’s office is a “temporary point” from where the baby will leave without a toothache and return to his usual activities. It is important that the baby comes to good mood, located to communicate, and the doctor will deal with the rest of the nuances individually, thanks to a whole arsenal of tools.

Summary

Milk teeth treatment compulsory procedure, the neglect of which leads to serious complications, long recovery and even lethal outcome. In order not to give the disease a single chance, you need to consult a doctor in a timely manner and undergo dental examinations. In children's clinics, several methods of treating pulpitis are practiced, talk to your doctor and choose the appropriate option. The hope that the disease will pass during the change of teeth is groundless. This attitude can harm the main teeth, which will remain for life. Monitor the condition of the baby, pay attention to complaints and immediately take to the doctor. In the case of health, it is better to be safe than to miss the moment.

Pulpitis is called inflammation of the pulp - tissues located inside the tooth. This disease poses a rather serious threat to the child's body as a whole. Therefore, it should be taken as seriously as possible.

For those who doubt whether there is pulpitis of milk teeth at all, we will answer unequivocally: it happens. And besides, it usually proceeds much faster than in adults. In children, hard dental tissues are thinner, and the dentinal tubules, on the contrary, are wider, which leads to the rapid development of infection inside the tooth. Therefore, in childhood, this disease is much more likely to acquire a chronic form with all the ensuing consequences.

Why does pulpitis of a milk tooth occur? How to detect it? And what should parents do if this misfortune befell their dear child?

Causes of pulpitis of milk teeth in children

Most often, according to dentists, this very unpleasant disease in childhood is caused by:

• Treatment of caries not carried out on time - in this case, microbes that develop in the carious cavity and decay under their action of tooth tissue provoke an active release of toxins. Under their influence, the inflammatory process of the pulp most often begins, which, if left untreated, can lead to very serious consequences.
• Acute transferred by the baby infection- in the course of the infection, pulpitis of the tooth in a child, as a rule, occurs against the background of a decrease in immunity and the appearance a large number bacteria.
• Injury of a milk tooth - this can be either accidental damage to a tooth during a game or rest, or too rough treatment of the oral cavity in the presence of caries, or even a careless action by a dentist;
• medical errors in the treatment of caries - inflammation of the pulp can develop under the influence of incorrectly selected filling material or due to the treatment of the oral cavity with too strong antiseptics, for example, alcohol, and also due to overheating of dental tissues during the preparation of a carious cavity.

The incidence of pulpitis

Many parents do not take their children to the dentist, believing that pulpitis cannot develop in a baby at 2 years old. Moms think that if they don’t give the baby sweets, then caries will not affect the enamel. Unfortunately, they are wrong. Tooth pulpitis can overtake a child at 2, 3, and 5 years.

• At the age of 2, pulpitis affects the anterior milk teeth of the baby;
• From 3-4 years old, children are more likely to suffer from pulpitis in back teeth. Often a child of 4-5 years old comes to the dentist, crying from pain in the molars. Surprisingly, such inflammations are several times more common than pulpitis in the front teeth in children.

What are the symptoms of pulpitis of milk teeth

To suggest that the child has pulpitis, they will help you:

Complaints about toothache

As a rule, it worsens in the evening and at night, as well as in the process of chewing food. There is almost always a reaction to cold or hot drinks. There may be pain when the tooth is tapped. With an exacerbation of the inflammatory process, the pain becomes constant aching.

However, it should be borne in mind that the rapid transition of the disease into a chronic form, characteristic of childhood often leads to the disappearance of pain. That does not mean that there is no problem. And you should visit a doctor even if the tooth has stopped hurting.

Swelling of the cheek (swelling)

This symptom can often be found in the photo of milk teeth. However, it is not always observed. And, in addition, it can also signal diseases such as periodontitis or periostitis. But pulpitis should not be ruled out either. Put accurate diagnosis only a doctor can. And you may need to take an x-ray.

Increased body temperature and deterioration in general condition

If a child has a strong the immune system, then a high temperature can also report the development of the disease. In this case, the body reacts to the inflammatory process that began in the pulp. And if there are no suspicions of other diseases accompanied by fever, be sure to show the child to the dentist.

If your baby has a toothache, or you observe any of the above symptoms, you should immediately visit a doctor. Perhaps it's time to start treating the pulpitis of a milk tooth. In any case, there is definitely a reason to visit the dentist's office.

How to treat pulpitis of milk teeth

If you suspect that your son or daughter has overcome this particular ailment, then the most correct thing is to seek professional help as soon as possible. Since the disease is quite serious, and it requires correct diagnosis and qualified medical intervention.

There is no need to remove the tooth at all. And what's more, early removal may lead to the formation malocclusion. The course of treatment of pulpitis in children largely depends on the stage of tooth development at which it was found.

The fact is that the pulp can be completely removed only in the formed roots (and this takes several years from the moment the tooth erupts). Therefore, in most cases, the doctor removes the pulp only partially. As a rule, at the same time, along with its part located in the crown of the tooth, carious foci are also removed. This procedure is performed after an anesthetic injection. After that, a medicine is placed at the bottom of the cavity and at the mouth of the channels, designed to disinfect the tissues left behind. Or, first, the pulp is also mummified by applying drugs, and then removed.

Over time, such a “pad” of drugs is replaced or left under a permanent filling.

When pulpitis of milk teeth, first of all, it is necessary to eliminate the inflammatory process and prevent complications in the form of periodontal damage, which can cause abnormal formation of permanent teeth. There are 3 main methods in total.

Biological method of treatment of pulpitis in children

A few years ago, dentists began to practice conservative methods of treating pulpitis in children. This conservative therapy does not require surgical intervention, is easier to tolerate by the baby and causes a minimum of complications.

Conservative treatment of pulpitis of milk teeth is carried out in stages:

1. The doctor opens the inflamed cavity.
2. Closes the bottom of the gums and pulp with a special mixture consisting of Shostakovsky's balm, calcemin and artificial dentin.
3. After the mixture dries, the dentist fills the tooth with fluoro-cement or phosphate-cement pads.

Physicians are ambivalent about similar procedure. Some consider biological treatment of pulpitis in children great way save the baby from pain and create the most favorable conditions for the development of the tops of the roots of permanent teeth.

Many dentists believe that conservative way treatment of pulpitis of milk teeth can provoke various inflammations periodontal.

In any case, the treatment of pulpitis of milk teeth requires repeated visits to the doctor and a serious approach. Therefore, stock up on perseverance and patience, and also try to properly set up the child so that every trip to the clinic does not become stressful.

Please note that general approach does not exist here. The inflammatory process proceeds differently each time. And to decide how to treat the pulpitis of a milk tooth, in each case, only a doctor can.

Possible mistakes in the treatment of pulpitis

Unfortunately, only not at first sight pulpitis of a tooth in a child is a simple ailment. Wrong treatment can provoke such nightmares as periodontitis, periostitis and even acute polio.

The most common mistakes in the treatment of pulpitis in children are:

• Incorrect assessment of the state of the pulp and, consequently, partial removal of inflammation. In this case, the baby will very soon suffer from a new exacerbation.
• Loose bandage when removing the pulp. AT rare cases doctors do not apply a temporary bandage with arsenic tightly enough, which can lead to burns and necrosis of the tissues of the cheek, tongue and mucous membrane.
• Arsenic overdose can cause acute periodontitis requiring more long-term treatment than pulpitis in a child.
• Periodontal injury with a root needle. Incomplete cleaning of root canals in the treatment of acute or chronic pulpitis in children can also provoke periodontitis.

Pulpitis treatment: how to set up a child

Pulpitis of milk teeth gives the baby a lot of trouble. It is not necessary to aggravate the already difficult days of the child, parents should definitely prepare him for a visit to the dentist.

Talk to the baby. Explain that the doctor will treat tooth pulpitis gently and the patient will not feel pain. It is important that visits to the dentist are not associated with torture chambers in the child. Choose a positive doctor that you trust and dental treatment will become an exciting attraction.

The main task of parents is not to let the disease take its course. Since chronic pulpitis of a milk tooth, which is most often found in the photo, can lead to a further spread of the inflammatory process and damage to the rudiments of permanent teeth.

And do not forget that it is always easier to prevent disaster. Therefore, do not allow pulpitis. Make sure your child brushes their teeth properly and regularly, using quality oral hygiene products. And be sure to visit your dentist regularly.

Pasta "for crumbs from 0 to 3 years old will help to quickly teach your baby to brush his teeth. The soft gel carefully cares for the teeth, reliably protecting them from caries. And the sweet taste of tutti frutti makes the procedure pleasant and tasty.

Pulpitis of permanent teeth in children

Pulpitis of permanent teeth in children is a common ailment among adolescents. Surprisingly, newly erupted molars are especially sensitive to external influences, because during the first few years they are not yet saturated with mineral components.

Pulpitis of permanent teeth in children most often develops against the background of deep or medium caries. And if in children with formed roots of the teeth, pulpitis develops in the same way as in adults, then in adolescents with only emerging roots, this ailment differs significantly from the usual for parents.

Symptoms of pulpitis of permanent teeth in children

Acute pulpitis

The features of pulpitis of permanent teeth with incomplete growth include:

• Spontaneous pains. Children complain of unexpected mild pain in the mouth. Unpleasant sensations occur suddenly, without visible reasons. Pain can torment a teenager for hours, or it can go away by itself in 15-20 minutes. Often the discomfort is various stimuli such as cold or hot food.
• At acute diffuse pulpitis permanent teeth in children, discomfort intensifies in the evening and at night. Soon the pains become constant, give to the temple, neck, ear or infraorbital region. Painkillers soon become ineffective.
• Softened dentin of the carious cavity, poorly pigmented, also indicates pulpitis of the tooth.
• Sharp throbbing pain radiating to trigeminal nerve is also a symptom acute purulent pulpitis with incomplete root formation. It is noteworthy that the pain is aggravated by the consumption of hot food or drinks and calmed by cold.

Chronic pulpitis

Chronic pulpitis permanent teeth with incomplete growth, as in milk teeth, can occur as a primary process without acute stage. For chronic inflammation characteristic the following symptoms:

• Aching spontaneous pain;
• Unpleasant sensations when eating or pressing on the tooth;
• Prolonged pain from cold or hot food;
• Bleeding pulp.

Chronic gangrenous or fibrous pulpitis of permanent teeth in children can occur both in the open and in the opened pulp chamber. For fibrous inflammation characterized by a chamber of dark red color, unpleasantly bleeding when touched. Gangrenous pulpitis is usually accompanied by secretions grey-green with a putrid odor.

Chronic pulpitis in children is sluggish, the pain returns every now and then. A teenager complains of bouts of pain spreading along the course of the trigeminal nerve.

Treatment of pulpitis of permanent teeth in children

Doctors distinguish two methods of treatment of pulpitis in permanent teeth. At the discretion of the doctor, therapy is carried out with partial or complete preservation or removal of the pulp. Let's consider each of the methods in more detail.

Conservative treatment

“A living tooth is more likely to survive than a dead one” - you have probably heard this common and, of course, fair phrase. Recently, dentists have mastered the biological method of treating pulpitis of permanent teeth in children, which is recommended for diseases such as:

• Pulp hyperemia;
• Traumatic pulpitis;
• Acute serous pulpitis;
• Chronic fibrous pulpitis without destruction of periodontal tissues;
• Acute pulpitis, lasting no more than a day;

Unfortunately, science has not yet advanced that far, and the biological treatment of pulpitis is effective in the good condition of the child and a shallow carious cavity.

For adolescents with incomplete root formation, dentists treat pulpitis by partial nerve preservation. This method contributes to the completion of the formation of the root system.

Surgery

Vital (complete) pulp amputation is performed in adolescents with completed root formation. The doctor excises the crown polka under anesthesia, and then acts various medicines on the pulp stump. Complete removal of the nerves and subsequent filling of the canals is carried out.

Treatment of pulpitis of permanent teeth in both children and adults is carried out under anesthesia. The patient does not feel discomfort during the processing and filling of the canals.

Surgical method The treatment of pulpitis with the help of devitalizing agents remains the most common method of dental treatment. To devitalize the pulp, dentists use arsenic preparations, as well as pastes with high content paraformaldehyde.

Prevention of pulpitis

Toothache can be avoided if you teach your kids to take care of their mouths from an early age. Be sure to visit a pediatric dentist twice a year, consult a doctor at the slightest unpleasant sensations in the mouth.

It is important to teach your child to brush their teeth thoroughly; at a young age, caring for them is especially important. And to make cleaning not only easy, but also pleasant, give your beloved son or daughter a gift designed for children aged 4 to 8 years. This sweet and fresh tasting gel paste will protect your teeth from caries every day and protect your gums from unpleasant inflammation.

Much more common than in adults is pulpitis of milk teeth in children. Symptoms, treatment, photos will be provided further and we will detail all the nuances this disease. We will talk about what it is, whether it is necessary to treat it and how dangerous it is to ignore the problem in this article.

The structure of a milk tooth is slightly different from an adult, permanent one, therefore, diseases have their own characteristics of the course, symptoms and treatment. To know how and what to react to if a child complains, what steps to take and what to choose when deciding on treatment, you need to be guided by the following nuances.

What is the peculiarity of pulpitis of a milk tooth?

This disease is considered quite common, because caries in babies quickly turns into deep tissue and contributes to the development of more serious problems. Tooth pulpitis in a child is an inflammation of the pulp of the milk unit. The following distinguishing features are observed:

• A thin layer of enamel and a small volume of dentin provide little or no protection. inner part from aggressive bacteria.
• An enlarged pulp that takes up more space and is much easier for pathogens to reach.
• Wide dentinal tubules contribute to the rapid spread of the disease.
• A good outflow of fluid from the inflamed areas significantly reduces pain and makes it impossible to detect a problem.

Because of these differences, parents do not always find out in time that active processes of tooth decay are taking place in the child's oral cavity. Therefore, it is worth paying attention to any complaints, even the most insignificant, that the baby is trying to show. Then the diagnosis in the dentist's office will be carried out on time.

Do not think that this problem only affected the child who brushed his teeth badly or ate sweets. The causes of the disease can be different:

• low immunity;
• weak enamel;
• the presence of carious cavities;
• violation of the processing of the unit during medical intervention during filling, turning or during periodontal treatment.

Symptoms and forms of the disease

In pediatric dentistry, the following classification is most often used:

Acute pulpitis, which, in turn, can be:

1. Focal, that is, partial.
2. Diffuse or general.

Chronic, which also has its own varieties:

1. Fibrous.
2. Gangrenous.
3. Hypertrophic.

If the cause of the disease was not bacteria, but an injury or incorrect actions of a doctor, then it is called traumatic.

Each of them has its own characteristics and characteristics, on which the chosen method of treatment will depend. So, in the acute variant of the development of the disease, there are noticeable pain from any external stimulus. But it happens that the pain appears at night. If a tooth with unformed roots, for example, in a child at 2 years old, then there may not be such sensations at all.

If the pain periodically appears and disappears, then this is most likely a partial pulpitis. When it is long, intense and the child cannot indicate which particular tooth is bothering him, then perhaps the disease has spread to general form. And if in this case you do not consult a doctor, then it can flow into periodontitis, and end general intoxication organism.

The stages of the disease do not always go through an acute phase, and in the absence of treatment they flow into some other one. It happens that initially pulpitis becomes chronic. Symptoms of the gangrenous form:

A photo

Treatment of pulpitis in children

The most important in the treatment process is the elimination of direct inflammation, the removal of the pulp or part of it and the prevention of development possible complications. If you do not pay due attention to this, then in addition to more serious complications in the surrounding tissues, future permanent teeth may also suffer, which, due to this problem, will form in the wrong way.

Often adults, not wanting to go to the doctor, decide to get rid of the disease with the help of folk remedies. In the case of pulpitis treatment, it can be calamus, hydrogen peroxide, lemon and various medicinal herbs. And yet, experimenting and risking the health of the child is not worth it. Consult a doctor who will make an accurate diagnosis and perform the necessary manipulations.

Modern medicine can offer several options for the treatment of pulpitis in children:

• biological;
• amputation;
• devital.

Let's talk about each of them in more detail.

biological method

This is the usual conservative method and it is considered traditional in pediatric dentistry. There are no major surgical interventions. The doctor carefully opens the inflamed pulp and fills it with a special mixture of Shostakovsky's balm and unnatural dentin. In some cases, Calmecin is used. After drying of this substance, the usual filling is carried out.

But today's young doctors are increasingly refusing to similar treatment, as it is fraught with complications, a long recovery process, unnecessary intervention and the possibility of inflammation moving to periodontium.

Amputation

Some clinics will immediately offer complete removal of the pulp or part of it. Of course, such a procedure is carried out in more than one visit and most often under anesthesia, because it is quite painful.

If they stop at partial removal, then affect only the coronal part. At the same time, the root remains to protect the periapical tissues from various pathogens. In the case when the bleeding cannot be stopped, a decision is made to completely remove the pulp.

For the procedure to be successful, the doctor must adhere to the following rules:

1. During the opening of the cavity, use several sterile tips to prevent infection of deeper tissue layers.
2. It is good to treat the tooth cavity with an antiseptic.
3. With the help of a selected dose of adrenaline, stop the bleeding after amputation.

When it comes to pulpectomy, that is, the complete removal of the pulp, you need to be especially careful not to touch the periodontal tissues. They try not to use this method everywhere, as it is painful, complicated and lengthy. However, the physician decides to treat or remove the inflamed pulp based on various indications.

Devital

This method also refers to the complete removal of infected tissue. But at the same time they act in a softer way. By using special means, which will gradually kill the inflamed tissue, several stages of treatment are carried out.

Applications are usually used arsenic paste and local anesthetics. But at gangrenous form recommend using formalin and phenol. Further, depending on the selected remedy, it is left in the child's dental cavity for 1-2 days or 7-14 days. Duration decision this stage is taken by a doctor on the basis of clear instructions for a specific drug.

And already at the next visit to a specialist, the cavity is cleaned and a tampon with a resorcinol-formalin mixture is placed. This is done in order to saturate healthy tissues with special substances that promote tooth growth. Thus, in addition to treatment, the oral cavity is prepared for the appearance of permanent units.

And only at the third visit to the dentist can we talk about the final stage, when the open cavity is sealed. In order to evoke pleasant emotions in a 4-5-year-old child from such a long treatment, the doctor can offer multi-colored fillings that the baby will like and decorate his teeth.

That is, the whole procedure will be quite lengthy. But at the same time, it is almost painless, it is carried out gently and gently, without stress for the child. It is also very important that painkillers and safe substances are used. Increasingly, pediatric dentists prefer this particular method of treating pulpitis in children. different ages. It can be used in almost any form of the disease.

Complications

Complications can follow, most often due to the illiterate actions of the doctor during treatment. These include:

• Initial misdiagnosis. And if the dentist removed only part of the inflamed pulp, then the remaining focus of infection will continue to destroy healthy tissue.
• Applying too little arsenic paste causes it to run out. If it gets on the mucous membrane, the medicine will quickly cause necrosis, hitting the inside of the cheek, tongue and gum.
• If there was too much arsenic or it was used when the roots of the milk tooth began to dissolve, then poisoning and intoxication of the child's body is possible.
• But too tight to lay the medicine is not recommended. After all, then you can provoke a burn of the mucous membrane.
• Careless actions of a doctor can lead to the development of a disease in a healthy part of the tooth or soft tissues under him. For example, if the dentist hooked the periodontium with a needle during treatment.

Prevention

Is it worth mentioning once again the most common dental guidelines, which are universal for children and adults and relate to the prevention maximum number oral problems:

Video: pulpitis of milk teeth in children.

Additional questions

What to do if a child has a toothache after pulpitis treatment?

Painful sensations can be associated with medical intervention and tissue irritation from medications. If the pain itself subsides over time, then this normal reaction organism. In the case when it appears after treatment and its intensity does not subside, then you should consult a doctor, as perhaps the procedure was carried out incorrectly and something needs to be corrected.

The child's temperature rose after pulpitis treatment

A fever in a child may be a simple reaction to stressful situation. And yet, ignore similar symptom not worth it, as most often it can talk about a serious inflammatory process. You should immediately consult a doctor and re-diagnose.

Like an adult, children's pulpitis occurs due to an infection that has entered the pulp chamber of the tooth. Due to infection with pathogenic microbes, the soft tissue becomes inflamed dental tissue- pulp. In young patients, the disease develops faster and is more difficult than in adults. This is due to the special structure of temporary teeth. The wide pulp chamber is surrounded by thin layers hard tissues of the tooth: dentin and enamel.

Pulpitis in children can occur against the background of a weakened immune system, due to protracted viral or infectious diseases: chicken pox, SARS, influenza, tonsillitis. In this case, the infection enters the pulp chamber by the hematogenous route - through the blood.

Other factors

Unskilled work of a dentist in the treatment of caries can infect the pulp in milk teeth. Or a periodontist in the treatment of gums, gingival papillae, alveoli and other periodontal tissues. Untreated periodontal inflammation can lead to pulpitis of temporary teeth in children. In this case, the infection enters the dental chamber through a special (apical) hole at the bottom of the tooth root.

Injuries to the tooth during bruises or falls of the child can lead to a fracture of his crown in the region of the pulp chamber and infection of the pulp.

Development Features

Pulpitis of temporary teeth, as well as permanent teeth, has two varieties: and. Often the transition from one stage to another goes unnoticed. Or the disease immediately takes chronic view currents.

Children's dental system contributes to a good outflow of fluid from the inflamed pulp. Due to this, pain sensations are blocked. Often the disease makes itself felt when it is no longer possible to restore the pulp.

The pulp is responsible for the "health" of the teeth, their sensitivity and protects periodontal tissues from carious destruction. Timely treatment help keep it alive. Therefore, it is recommended to take the child to scheduled checkups to the dentist two to four times a year.

Acute serous phase

The acute form of pulpitis of milk teeth in children is less common than chronic, but is accompanied by a bright severe symptoms. It is divided into two phases - stages of development: serous and.

The serous phase is accompanied by the filling of the pulp chamber with a clear yellowish liquid. It is formed from the blood that has flowed out of the vessels of the pulp under the influence of inflammation. The child is tormented by acute periodic pain. They appear at night and during exercise, for example, while chewing food.

Acute purulent phase

A few hours later, the serous phase flows into the purulent. Under the action of inflammation, pulp tissues disintegrate, accompanied by the release of purulent fluid from the neurovascular bundle. There are acute prolonged pains that can be given to other teeth or different areas of the head.

Pain subsides when eating cold foods or drinks. The child may feel unwell, refuse to eat, he may have a fever from high temperature. There are swollen lymph nodes under his jaw.

Acute stages of development of pulpitis of a milk tooth can be painless. This is possible if the child has strong immunity, all body systems work well, and serous and purulent fluids flow through the carious cavity.

chronic variety

Pulpitis of a milk tooth of a chronic variety can occur as an independent disease. Or appear in the process of development acute variety. Sometimes chronic form pathology develops inside the cured tooth, under the filling.

Chronic pulpitis on milk teeth has three levels and individual signs:

mental preparation

Treatment of pulpitis of milk teeth in children has certain features. Most young patients are afraid to go to the doctor. But it cannot be postponed, otherwise the inflammation can spread to the periodontal tissues and go deep into the jaw bone. If the disease is started, infection is possible circulatory system and even death.

To calm the child, you need to prepare him in advance for the upcoming visit to the dentist and treatment. Tell about the importance of the procedure, about the kindness of doctors, about maintaining health. Play doctor. Honestly, it will hurt a little, but the doctor will give an injection and everything will pass.

At the dentist's appointment

It is advisable to make the first visit preventive: give the child the opportunity to get acquainted with the situation, talk with the doctor, touch the instruments with his permission.

If the child continues to be nervous, on the second visit, the dentist will give him depressant. It can be "Sibazon", a mixture of citral, "Mebikar". To choose medicinal product and its dosage should only be the attending physician, self-treatment may harm the health of the child.

Consider how a childhood illness is treated.

Conservative therapy

There are three methods of treatment of pulpitis of milk teeth in children: conservative (biological), amputation and pulpectomy. Any manipulations are carried out after the anesthesia has taken effect.

If, apart from pulpitis, the child has no other diseases, and the inflammation of the pulp has just begun, a conservative biological method of treatment is used.

The dentist gets rid of carious lesions. Opens the pulp chamber and fills it with a special mixture consisting of powdered artificial dentin and Shostakovsky's balm (polyvinyl butyl ether). Calmecin is sometimes used instead of the mixture. As soon as the mixture dries, the doctor fills the tooth and recreates its anatomical shape.

The disadvantage of this method is a long recovery. The child should be periodically observed by the dentist in order to avoid complications.

The remaining methods of treating pulpitis in children are based on surgical intervention, in which pulp tissue is partially or completely removed.

Amputation method

The purpose of the amputation method is to preserve the functionality of the pulp. It is achieved by removing part of the pulp tissues located in the dental crown. Part of the pulp in the roots of the tooth remains to perform nutritional and protective functions.

The dentist opens the pulp chamber using several sterile tips. Such measures are needed to prevent infection of other layers of dental tissues. Then the doctor processes the inside of the tooth antiseptic preparations. To stop the bleeding after cutting off part of the pulp, he uses adrenaline. If the bleeding does not stop, the entire pulp is removed.