Pulpitis in a 5-year-old child. Is it necessary to treat pulpitis in a milk tooth? Partial or complete removal of the pulp

Among many parents, there is a very stable and at the same time dangerous delusion that milk teeth, unlike permanent ones, do not need to be treated at all. Like, it is pointless to treat caries and even pulpitis of milk teeth, since these temporary teeth will soon give way to permanent ones anyway. The most striking thing is that even the onset of severe pain in a child often does not become an argument capable of destroying such a delusion. Meanwhile, such an attitude to the treatment of milk teeth can lead to the most unpleasant and even dangerous consequences.

What is pulpitis?

The development of pulpitis in childhood is most often caused by neglected caries. In comparison with an adult, a child experiences less pain during pulpitis of a temporary tooth, and this gives rise to the practice of parents using improvised means that are unable to help in solving this problem.

If you start the treatment of this disease, then the pulpitis of milk teeth in a child can provoke various complications, in particular, periostitis or periodontitis, but the saddest thing is that even deaths caused by infection of the baby’s blood are known. In order not to pose a threat to the life and health of the child, caries should be treated on time, but if the treatment was late and pulpitis began, then in no case should you try to drown out the pain on your own or wait until the tooth falls out, you should contact a specialist as soon as possible for help.

Forms of the disease

Speaking about pulpitis in children, we can distinguish its following forms:

Hypertrophic. The rarest variety, develops as a result of prolonged exposure to irritants. The child does not feel any special pain, except for a slight property during the process of eating, but the gum bleeds when probing, in addition, its characteristic features will be an overgrown pulp tissue and a completely destroyed crown.
Gangrenous. Despite the slight pain felt, the child has a discoloration of the tooth enamel and its darkening. There is no special depth in the carious cavity, but due to the decay of the pulp and exposure to pathogens, an unpleasant putrefactive odor from the mouth is noted. A likely consequence may be inflamed lymph nodes and the appearance of a fistula.
Chronic. This form of childhood pulpitis develops as a result of caries in its shallow form. An exacerbation usually occurs as a result of a decrease in immunity, the symptoms will be: swelling of the soft tissues, constant pain, which, when the slightest impact on the tooth, begins to intensify, as well as a clear deterioration in the child's well-being.
Exacerbation of chronic pulpitis. This usually happens when the child's immunity is weakened, combined with a poor outflow of harmful secretions. As a result, a child of 3–5 years old complains of aching pain, which, when the slightest impact is exerted on the tooth, intensifies, swelling appears, and the lymph nodes become inflamed. The carious cavity is distinguished by varying degrees of its depth, and the susceptibility of nerve endings is at a low level. Detection of such problems becomes possible with the help of an x-ray.
Acute partial pulpitis. Another rare form of the disease, the pain is minor and the disease quickly develops into general pulpitis.

Symptoms of the disease

Pulpitis of milk teeth is distinguished by a rare variety. Often there are cases when the child does not complain about any problems at all, but it happens that the patient has all the acute symptoms of the disease. Worst of all, due to the looseness of tissues inherent in milk teeth, children's pulpitis often causes periodontitis, in adults such a transition occurs much less frequently.

Diagnosis of pediatric pulpitis is difficult, because, unlike an adult, a child can rarely accurately convey his feelings to the doctor, so the initial stage is often overlooked by parents and a small patient comes to the dentist with an already acute form of the disease.

The main symptoms of this disease will be:

paroxysmal pain, aggravated by exposure to the tooth;
swelling of the tissues around the affected tooth;
lymphadenitis;
deterioration in the general well-being and condition of the child.

Traditional approaches to the treatment of pulpitis of temporary teeth in children

The simplest solution to the problem of children's pulpitis is the elimination of the problem tooth, but only in theory, in practice, it should be understood that such a surgical intervention, firstly, can psychologically injure the child, and secondly, can cause malocclusion in the future. Therefore, it is advisable to put treatment in the foreground, and talk about removal in situations where there are no other options left.

The current standard practice of treating pulpitis in children is based on the already outdated method of devital amputation, which can in a certain sense be called concern for the mental state of a small patient, because when using this method, dental instruments do not affect the dental canals. The essence of the technique is that an arsenic or devitalizing paste is placed on the problematic tooth, the first acts faster, no more than two days, the second takes more time, about one week. After that, during subsequent visits to the doctor's office, the resorcinol-formalin mixture and paste are pumped into the dental canals, which, due to the mummification of the affected pulp, prevent its further decomposition. At the end, a filling is placed on a temporary tooth.

After a certain time after the completion of the treatment procedure, the teeth are stained in various shades of red, but this is not the most difficult consequence of this treatment technique. Much more problematic is the fact that the paste used by the dentist causes a kind of plug in the canals of already permanent teeth and the subsequent treatment of such a tooth becomes difficult, and sometimes fundamentally impossible.

Modern methods and means of treatment of pulpitis of milk teeth

When a child is able to withstand, due to his calmer temperament, a rather long treatment of pulpitis, then the method of vital or devital extirpation is used to combat the disease. During the first visit to the dentist, during vital extirpation, the “nerve” is immediately removed from the canal, and during devital extirpation, a special paste is placed to destroy the affected pulp. After that, the dental canals are processed mechanically and with the help of medicines, the pulp is further extracted and sterilization is performed. Further, with the help of the paste, the canals are filled, while the need for its use is determined by the anti-inflammatory effect of this paste. Over time, along with the roots of the temporary tooth, this paste is resorbed. Zinc-eugenol paste, which is very popular among doctors, as well as Magipex paste, showed good results in dentistry.

There are many supporters of another method - vital amputation. In this case, only partial removal of the coronal part of the "nerve" is subject to removal, after which drugs are placed on the pulp, for example, "Pulpodent" or Pulpotec. These drugs have excellent anti-inflammatory properties, in addition, they keep the pulp in a normal state and block pain, and they do this not only during the treatment procedure, but also after it is completed.

The specifics of the treatment of pulpitis of a milk tooth with unformed roots

Unformed roots are understood as the roots of a milk tooth, in which, when they erupt, the tip remains uncovered. Treatment of pulpitis of such teeth in children is associated with some difficulties, which are caused by the very structure and features of the root structure:

small length;
large width of channels and apical openings;
any violation of the tissues of the apical part of the root can provoke their destruction, which dictates the need for all operations to be carried out with extreme caution and accuracy.

It is impossible to use the extirpation technique in this case, so doctors in most cases have to turn to amputation or biological treatment:

amputation method. It is very popular and is built on the extraction of the affected pulp from its chamber.
biological method. It is based on the preservation of the pulp in its normal state, while it must be taken into account that it has a lot of contraindications and is extremely demanding on the observance of antiseptics during work, otherwise the return of pain cannot be avoided. First, the cavity affected by caries is cleaned from dead tissues, after which a paste is placed on the bottom or directly on the pulp, and a filling is placed a few days later.

Possible errors in treatment and how they threaten the child

Statistically, errors in pediatric dentistry occur more often than in adult dentistry, due to the specifics of working with young patients. Often, children simply do not give the doctor the opportunity to work normally, arranging real tantrums and demonstrating absolutely inadequate behavior. That is why dentists are often literally forced to use devital amputation, since they are not able to solve the problem in other ways. However, there are also medical errors in pediatric dentistry, even if they are partially caused by the behavior of a small patient, which makes it difficult to complete the treatment procedure:

Incorrect setting of the paste necessary for pulp devitalization. Worst of all, if the paste is arsenic, often because of the behavior of the child, it does not fall on the “nerve”, but on the bottom of the cavity, resulting in quite strong pain. The solution to the problem is to reinstall the paste.
Installation of devitalizing paste on the gum. The result is severe pain and burning of the gums, which should be combated with the use of anti-inflammatory drugs.
Output of dental files beyond the root. Because of this, bleeding occurs as a result of injury to adjacent tissues.
Broken instrument in the canal. The consequence of this error can be inflammation of the tissues located near the root and the development of periodontitis.
Root perforation causing similar effects.

How to prepare a child for treatment?

Many adults are afraid of the dental chair, it is not surprising that such a fear is massively present in children. So that the child does not have a fear of dental treatment, a preventive visit to the doctor should be made before any problems with the teeth arise. This familiarization visit will allow the little person to get acquainted with the situation, to study the tools and it often happens that curiosity takes precedence over fear. However, in any case, children need to be prepared for a visit to the dentist, and for this purpose, doctors recommend doing the following:

talk about the upcoming visit a few days before it, so that peers do not scare him with various “horror stories”;
emphasis should be placed only on the positive side of the issue;
too much attention should not be paid to this topic, since it is necessary to form the idea that health care is a common and even somewhat routine matter;
Present a visit to the dentist as an opportunity to meet a new friend;
play "to the hospital" at home, showing by personal example the absence of fear of the doctor;
avoid the use of "terrible" dental terms and words;
keep yourself in control and do not show your excitement;
it is best to visit the office in the morning, while the child has not had time to get tired during the day;
it’s good to take your baby’s favorite toy with you so that it gives peace to the little patient;
do not interfere with the work of the doctor and do not interfere with him to independently establish contact with the baby;
do not intimidate or beg your child if he refuses to go for the procedure.

The reasons

The most common cause of pulpitis is advanced caries. A developing infection first of all strikes at the tooth enamel, then goes to the dentin and then moves directly into the pulp. Sometimes, however, pulpitis occurs as a result of trauma, including exposure by the dentist during the treatment of caries of the nerve.

How to recognize the problem in time?

Due to the fact that in children the pulp is characterized by reduced sensitivity, it often happens that the disease develops imperceptibly, since the child does not experience pain. This fact alone is already enough to confirm the need for regular visits to the dental office for preventive examinations and timely treatment of caries.

Signs of serious dental damage

The absence of pain does not mean that the symptoms of such an ailment are impossible, in such a situation they will help:

discomfort and some soreness when taking cold and hot food;
the appearance of stains on the tooth and an unpleasant odor;
the beginning of the inflammatory process in the tissues surrounding the tooth;
fever and worsening general health.

If such symptoms appear, not to mention the occurrence of pain, you should immediately take the baby to the dentist to provide timely assistance.

Is it worth treating milk teeth for pulpitis?

The very formulation of such a question is fundamentally wrong, since there can be only one answer - it is definitely worth it and as soon as possible. Painkillers and the expectation of tooth loss can lead to very unpleasant and even tragic consequences, up to death.

How is pulpitis treated in children?

With how to treat pulpitis in a child, the doctor is determined during the examination of the patient and finding out a large number of different factors and aspects, in particular, the place where the tooth is located, the degree of spread of the disease, and the like.

So, how is children's pulpitis treated? Among the methods used are the following:

treatment of the crown or root part, which allows to ensure the safety of the pulp;
incomplete removal of the pulp, performed when its functionality needs to be preserved, in such a situation the coronal pulp is subject to removal, as for the root pulp, it remains in place, since without it it is impossible to talk about the dentition and its formation in the future;
complete elimination, accompanied by canal filling.

Prevention

The key to prevention is just-in-time caries treatment. In order to prevent the process of infection of the tooth, it is necessary to pay close and serious attention to oral hygiene, you should teach your child to brush their teeth from an early age. Proper nutrition of the baby is of great importance, so, all the substances necessary for the development of the body should be added to his diet. Sweets must be limited, and at night refuse food, using only water.

Possible errors in treatment and how they threaten the child

During the treatment of pulpitis of milk teeth in children, medical errors are more common than in adult dentistry. This is due to the specifics of children's reception, when often the child prevents the doctor from carrying out all the necessary manipulations with due accuracy and in full. To minimize the severity of errors and for violent children, pediatric dentists can resort to devital amputation by the resorcinol-formalin method, since otherwise the child simply does not give the opportunity to save the milk tooth until its physiological replacement.

In pediatric dentistry, in the treatment of pulpitis of a milk tooth, for example, such an error occurs as an incorrectly supplied paste for pulp devitalization. The most difficult result of such an error is tolerated if the paste is arsenic. If the child does not allow the tooth to be treated with high quality, then it is placed by the doctor not on the opened “nerve”, but on the soft bottom of the prepared cavity, which often not only does not work, but also causes even more severe pain. The first aid in this case is to put the paste on again.

There are cases of placing a devitalizing paste next to or directly on the gum, since in children the carious cavity is often occupied by an overgrown gum or is close to the gingival papilla. The consequence of this is severe pain, and upon the arrival of the child to the doctor, a burn is found on the gum caused by the components of the paste. The prevention of such a complication is the observance of the technique of setting the paste, and when receiving a burn, it is required to prescribe anti-inflammatory wound healing gels or pastes.

During the treatment of canals in a milk tooth with pulpitis, bleeding may occur due to the fact that the tops of the roots may not be formed or are already slightly resorbed, and the files for canal treatment (special needles) can be forcefully removed by the dentist beyond the root, injuring adjacent tissues . Stop bleeding even with special drugs can be difficult.

Sometimes an inexperienced doctor can make mistakes such as root perforation and breaking off an instrument in a tooth canal. Since the canals in milk teeth are almost always very wide, the percentage of such complications is very low, but the severity is the same as in the case of permanent teeth in an adult. As a result of perforation of the root of the tooth and breakage of the instrument in the canal, periodontitis or periostitis may subsequently develop due to inflammation of the tissues around the root.

To prevent these complications, the pediatric dentist removes the instrument fragment from the canal in an accessible way, and closes the perforations with a special material, for example, ProRoot MTA. In some cases, in the absence of the necessary equipment and materials, the doctor simply mummifies the canals using the resorcinol-formalin method.

The photo shows an example of an instrument broken off in the canal of a tooth:

How to prepare your child for treatment

In order for the child not to be afraid to treat his teeth (even with severe pain during pulpitis), it is necessary to carry out the first preventive visit to the pediatric dentist long before that. The success of the first visit depends equally on the dentist and the parents of the baby.

The visit should be introductory. During it, the child gets acquainted with the new environment of the office, tools, showing only curiosity, not fear, but even such a visit requires preparation.

Before going to the dentist, follow these recommendations:

talk to the child before the preventive visit 1-2 days before he hears "horror stories" from peers;
tell your child only about positive impressions;
do not overemphasize the importance of the event, as health care is a common procedure;
talk about a future visit to the dentist, like meeting a new friend;
play “the dentist” with the whole family: set an example that you are not afraid of the doctor yourself;
do not use scary dental words;
do not deceive the child that it will not hurt, it is better to say that it may be unpleasant at first, but then the tooth will not hurt;
do not experience fear and panic yourself, then it will not be transmitted to the baby;
the best option for a visit to the dentist is in the morning when the child has had enough sleep, ate well and is active;
it is better if you go to the dentist with your favorite toy so that the child constantly fiddles with something in his hands;
let the doctor find contact with your child without your help;
if the child resists, interferes with the reception, then he should not be intimidated, threatened, begged, etc.
you should try to win the trust of the child, so if the situation is out of control, then it is better to postpone the appointment for the next time.

If the child is initially uncontrollable and anxious, often falls into hysterics, then he should be prepared with medication, relieving him of the upcoming stress. The over-the-counter drug Tenoten for Children is ideal for this. 20 minutes before the treatment of caries or pulpitis of milk teeth, one tablet should be given to the child under the tongue for resorption.

With high or moderate stress, Tenoten relieves tension, causing inhibition of mental processes. As a rule, after 20-30 minutes the child allows all the necessary manipulations to be carried out.

In order for the child to feel comfortable in the dental chair, it is necessary to start contacting the dentist for the purpose of prevention. With the proper level of hygiene, timely preventive examinations and quality control of toothbrushing, you can avoid not only pulpitis, but also caries, and save your baby's teeth until their physiological change.

An interesting video about the importance of treating pulpitis of milk teeth

A few more useful doctor's explanations regarding pulpitis of milk teeth

Pulpitis

Silvering

Removal

Caries is a fairly common problem with children's teeth, and many parents believe that its treatment is not so important, since the teeth are milk teeth and they will soon fall out on their own. However, such irresponsibility often leads to complications, one of which is pulpitis.

What is pulpitis?

This is the name of the inflammation of the dental pulp, which is a connective tissue deeply located inside the teeth with nerves, blood and lymphatic vessels. In folklore, the pulp is often simply called the dental nerve. The disease mainly affects milk molars, while the lower teeth become inflamed more often, although pulpitis of the front milk teeth also occurs. It is important to note that in childhood, due to the low strength of dentin and thin enamel, pulpitis develops faster than in adults.

The reasons

The most common cause of pulpitis is the lack of treatment for caries. The infection first affects the enamel, then spreads to the dentin and, as a result, enters the pulp. Much less often, the development of pulpitis is provoked by trauma to the tooth, including accidental exposure of the nerve caused by the dentist during the treatment of caries.

Symptoms

Depending on the course, pulpitis can be both acute and chronic. Acute is less common, but its symptoms are more pronounced. The process goes through two stages:

Serous, during which the pulp becomes inflamed with the filling of the channels with serous fluid. The child begins to complain of very severe pain in the tooth, which usually appears at night or during chewing. Pain is usually one-time, and the lesion is often observed in teeth with absorbable or incompletely formed roots. After 4-6 hours, the process proceeds to the next stage.
Purulent, during which purulent contents begin to form in the channels. The severity of this form is influenced by various factors, for example, the immunity of the child, the activity of bacteria or the condition of the roots of the tooth. Painful sensations may not be pronounced if the child's immune system works well, the microorganisms in the tooth are weakened, and pus comes out through the carious cavity. But much more often the pain syndrome is pronounced strongly. The pain is very long, sometimes given to other teeth, and appear when chewing, and when the temperature of the food consumed fluctuates. The child refuses to eat and often cannot even touch the tooth. The general condition of the baby may worsen with the appearance of fever and swollen lymph nodes.

Chronic pulpitis often occurs without symptoms, and it can develop both in deeply carious teeth and under fillings. The tooth can hurt from food getting into the hole or from a cold drink, which is why the child usually does not eat on the “sore” side. In the gangrenous form of the disease, pain in the tooth appears after a hot meal after a while, an unpleasant odor spreads from the tooth, the child may feel fullness and heaviness in the tooth.

How to recognize the problem in time?

Since the sensitivity of the pulp in children is reduced, the disease often develops without pain. For the timely detection of pulpitis, it is important to visit the dentist regularly with the child, as well as to treat all teeth affected by caries at an early stage.

Signs of serious dental damage

The following symptoms will tell you that it is important to show your child to a pediatric dentist as soon as possible:

Severe pain in the tooth.
The appearance of pain when eating hot food or cold drinks.
Bad smell from a discolored tooth.
Inflammation of tissues around the tooth.
Increase in body temperature.

Is it worth treating milk teeth for pulpitis?

The question of the need for treatment of pulpitis should not arise at all. If a child has this disease, it should be treated immediately. It is unacceptable to give a child painkillers and wait for a diseased baby tooth to fall out. Without treatment, such a problem with the teeth can result in serious complications, such as periostitis or periodontitis.

There were also fatal cases when an infection from an infected pulp entered the child's bloodstream and provoked severe swelling of the face.

In the following video, a pediatric dentist will tell you why it is so important to treat milk teeth and how to do it.

Stages and methods of treatment

Sometimes pulpitis is so severe and threatens the life of the child that the easiest way is to remove the tooth completely. However, in most cases, the doctor tries to save the milk tooth in order to prevent malocclusion. At the same time, dental treatment in budgetary organizations and private clinics is different.

Traditional

In most pediatric dentistry in public institutions, pulpitis is treated in a way called "devital amputation." It includes several visits to the dentist:

On the first visit, the nerve is opened and a paste with devitalizing properties is applied to it (it “kills” the pulp). If it contains arsenic, then the paste is kept in the tooth for 24-48 hours. Paste without arsenic is laid for a period of up to 7 days.
In the next two visits, a special mixture is “pumped” into the canals of the tooth to mummify the infected pulp. Usually it is a resorcinol-formalin mixture.
On the next visit, a permanent filling is placed.

Modern

If the child is calm and can withstand a long stay at the dentist, as well as in the case of formed tooth roots, a treatment method called extirpation is used. It is vital, when the nerve is removed from the tooth at the first visit to the doctor, as well as devital, in which the pulp is opened and treated with a paste for killing.

When the canals of the tooth are carefully processed, the infected tissues are removed and sterile conditions are created, an anti-inflammatory paste is used for their filling, which will dissolve along with the roots during the period of teeth change. The most commonly used zinc-eugenol paste. The method is effective, but in order for the infection not to become active again, the cleaning of the channels must be very thorough.

Another modern method is called vital amputation, the essence of which is to remove the upper section of the nerve and install a drug with antiseptic and anti-inflammatory action on the remaining pulp (Pulpodent and Pulpotek materials are often used). The medicine hermetically closes the lower part of the pulp, keeping it viable.

The specifics of the treatment of a tooth with unformed roots

The roots of milk teeth are formed for a long time after eruption, so situations are possible when a tooth becomes infected with caries, at the roots of which the top has not yet closed. The difficulties of treating such a tooth are due to such factors:

The roots in the teeth are short, and their canals are wide.
The upper part of the roots represents the "growth zone", the trauma of which will prevent the formation of the root.
There is a fairly high risk of infection of the permanent tooth germ.
All manipulations are important to perform as accurately as possible.
The filling material and instruments must not be allowed to leave the area in which the expansion of the apical foramen begins.
Completely remove the pulp and process all the channels will not work.
The best solution would be an amputation method of treatment. It consists in removing the infected pulp from the tooth in any way (with or without arsenic).
The biological method is also often used, the essence of which is to clean the tooth from dead tissues and put a medical paste with calcium hydroxide into it for several days, after which a permanent filling is installed.

Preparation for treatment

So that the baby is not afraid of dentists, the first visit should be preventive. It is carried out only to familiarize yourself with the environment of the doctor's office and the tools used. Before you go to treat your teeth, you should:

Talk to your child about doctors who treat teeth.
Tell the baby about the positive effects of treatment.
Emphasize that this is a procedure familiar to all people to take care of their health, and not something very important and exceptional.
Play "dentistry" with toys and family members.
Do not scare the child with scary terms.
Do not lie that there will be no pain. It is better to say that discomfort is possible, but as a result, the toothache will stop.
Do not panic and do not be afraid of the parents themselves, so that the excitement is not transmitted to the child.
Visit the doctor in the morning when the child is active, not hungry or sleepy.
Take your favorite toy with you so that it remains in the hands of the child during the visit.
Give the doctor the opportunity to communicate with the child without parental participation, so that the doctor can find contact.
Do not intimidate or beg the child if he is not allowed to be examined.
If you lose control of the situation, reschedule the appointment for another time.

On the site for moms, you have already read the site about how important timely treatment is. Because if caries is not treated, even when the tooth is milk, there is a serious risk of complications, and one of them is pulpitis. We talk more about this today.

Pulpitis of a milk tooth is an inflammation of the pulp, a connective tissue located deep inside the tooth, in which lymph vessels and blood vessels, as well as nerves, pass. The pulp is often referred to as the nerve.

Usually it is the milk tooth that suffers from this pathology. More often, inflammation occurs in the lower dentition, but it also happens that the front teeth are affected.

It is children who often suffer from inflammation of the pulp, because at this age the dentin has little strength, and the enamel is too thin.

Let's talk about the reasons

As you read at the very beginning, pulpitis of milk teeth in children most often occurs due to the fact that caries has not been cured. First, the infection enters the enamel, then spreads to the dentin and then penetrates into the pulp.

There are other reasons - tooth trauma. Sometimes it occurs just when visiting a dental office, when a specialist accidentally exposed a nerve in the course of treatment.

Symptoms

Pulpitis that develops in the thickness of a milk tooth can be acute or chronic. The first is less common, but the symptoms are more pronounced. The inflammatory process takes place in two stages.

Serous. There is inflammation of the pulp, and its channels are filled with fluid with serous cells. At the same time, the child complains that it hurts too much inside the tooth. Usually, such sensations appear during a night's rest or in the process of chewing. Usually the pain is single. The lesion occurs in the teeth, the roots of which are resorbed or not yet formed. This stage takes from four to six hours, and then the process flows into the second stage.
Purulent. Pus forms in the channels. How difficult the pathology will proceed depends on a number of factors: what kind of immunity the baby has, how active the bacteria are, what condition the roots of the tooth are in. Soreness may not be very pronounced if the immune system works like clockwork, the bacteria are weak, and pus flows out through the carious cavity. But more often the pain is severe and prolonged. Sometimes more than one tooth hurts, but sensations are given to others. Pain occurs when chewing, as well as if you eat food at different temperatures. The child may refuse food and is afraid to touch the tooth. The general condition may worsen. Other symptoms join: fever, swollen lymph nodes.

How to understand in time that a child has pulpitis?

It is better to start treatment of pulpitis of milk teeth in children as soon as possible. But the problem is that the sensitivity of the pulp at such a young age is usually reduced. Therefore, the development of pathology can proceed without pain. In order to detect pulpitis in a timely manner, it is worth visiting the dentist regularly and treating caries at an early stage.

The following signs indicate that you need to go with your child to the dentist:

pain in the tooth is pronounced;
pain occurs during the use of hot food or cold drinks;
unpleasant comes from a darkened tooth;
there is inflammation around the dental tissues;
temperature increases.

If the tooth is milk, is it treated?

The site has already touched on this issue in response to the opinion of some people that if a milk tooth is not treated, it must be removed. In this case, the same thing: treatment is necessary.

It would be wrong to give the baby painkillers and wait for the milk tooth to fall out on its own.

If you do not take the right actions, then complications are possible: periostitis, periodontitis. We do not want to scare you, but we simply must warn that the infection can enter the bloodstream and provoke swelling.

How is the treatment going?

It happens that the process is very running, and there is a threat to the health of the baby, then it is easier to remove the tooth. But sometimes they try to save a milk tooth so that later there is no malocclusion.

Let's take a look at some therapies.

Devital amputation - for this you need to visit the doctor several times. First, the nerve will be opened and a paste will be applied that has devitalizing characteristics, that is, it allows you to “kill” the pulp. If it contains arsenic, then you need to keep the paste for a day or two. A remedy without arsenic is applied for a week.

In the next couple of visits, the canals are filled with a special mixture that allows the pulp to be mummified with a developing infection. Then a permanent filling is placed on the milk tooth.

Another method is extirpation. It can be vital - in this case, at the first visit, the nerve is removed. Another option - devital - the pulp is opened and then processed with a special paste in order to perform the killing.

With careful processing of dental canals, tissues infected with bacteria are eliminated, sterile conditions are created.

In order to carry out a filling, a paste with an anti-inflammatory effect is used. It will begin to dissolve, like the roots, during the period when the milk tooth is replaced by a permanent one. Zinc-eugenol paste is often used.

The method is effective so that the infection cannot be activated again. But the channels should be cleaned carefully.

With vital amputation, the upper part of the nerve is removed. A drug with anti-inflammatory and antiseptic effects is installed on the remaining part of the pulp. The lower part of the pulp is closed with a fairly high tightness, which allows you to save its viability.

How is a dental unit treated if the roots are not formed?

When a tooth is a milk tooth, its roots form over time even after eruption has occurred. That is why it happens that when infected with caries, it is precisely that milk tooth that suffers, the roots of which are not yet covered by the top.

Pulpitis is difficult to treat taking into account such factors:

the roots are short, and the canals, on the contrary, are wide;
the upper part is the so-called growth zone, when it is injured, difficulties arise with the formation of a root;
there is a rather high risk of infection of the rudiment of a permanent dental unit.

Treatment of pulpitis of milk teeth should be performed with the utmost care and thoroughness. The filling material and instruments should not be allowed to go beyond the zone in which there is an extension of the special apical opening.

It must be understood that it will not be possible to remove the pulp completely, as well as to process all the channels. Therefore, it is better to use the amputation method of therapy. The infected pulp is removed from the tooth. The biological method is often used, and its essence is to get rid of dead cells, as well as laying a healing paste for several days.

Preparation for therapy

Treatment of caries and pulpitis of milk teeth requires proper preparation of the baby for going to the dentist. Often children are afraid to undergo treatment due to fear of doctors and the instruments they use. Therefore, before eliminating pulpitis, you need to talk with the baby.

Tell that the doctor helps, that therapy is useful. It is important to emphasize that all people undergo this procedure, it is not some kind of exceptional. Often a child, because of misunderstanding and fear, thinks that they want to punish him in this way.

When a child has pulpitis, he is already scared, so you don’t need to show your panic and scare him with this. Also, do not beg the baby if he is too resistant and naughty. Perhaps it’s worth playing a game about how toys treat each other’s pulpitis before a visit to the doctor.

Many children, what's there - even adults are afraid of dentists, and often because of stereotypes, as well as the neglect of the situation. In order not to remove the dental unit, you need to follow the rules of hygiene and do prevention.

Few children are able to calmly respond to a visit to the dentist. Most of all they are afraid of a drill - an unknown, very noisy and suspicious device. But the situation can become even more problematic if a sharp toothache is added to this, indicating childhood pulpitis. To avoid this, you need to know exactly how to prevent and determine tooth pulpitis in children.

Pulpitis in children is the same inflammation of the pulp that occurs in adults. But, as a rule, this disease is more common in childhood. A similar pattern is associated with a rather loose connective tissue of milk teeth, as well as wider root canals and less mineralized dentin. Also, milk tooth pulpitis is more common than molars because children have immature immunity. That is, the risk of having any inflammation or a common cold is much higher than in adults. But nature has balanced this trouble as well - there are practically no pain effects in children. However, the absence of pain is not always a sign that there is no problem.

Pulpitis of milk teeth is a common disease in children.

Disease classification

It is quite problematic to detect pulpitis in a child of 2 years old, but if you know the types of such inflammation, then the chances of timely diagnosis of the disease will increase significantly.

Pulpitis of hypertrophic type

This type of pulpitis in a child 3 years of age or older is very unlikely and is mainly the result of long-term chronic irritation. The signs of this inflammation are considered to be an almost completely destroyed dental crown, as well as a connective tissue that has grown due to prolonged damage. And although at the same time, pain in children is not observed, except for a slight pain during chewing, when probing, the tooth begins to bleed. It is also important that during the diagnosis of pulpitis in children 4 years old or other age, the doctor can distinguish the manifestations of its hypertrophic form from the periodontal granulation tissue, as well as the gum papilla.

Gangrenous pulpitis: symptoms

The development of the gangrenous form of the disease of non-molars is mainly a consequence of acute diffuse inflammation, which, in turn, often begins to develop from acute focal pulpitis in children. In this case, there is a darkening of the diseased tooth and the practical absence of pain. During the examination, a putrid odor from the mouth, caused by tissue breakdown, is sometimes detected, but the carious cavity remains mostly shallow. On the gum, in the region of the root apex, a swollen fistula can be found. Also, there are frequent cases of painless enlargement of the lymph nodes in a child.

Chronic pulpitis

Most often occurs with shallow caries, without affecting the tooth cavity, and prevails over the acute variant of the course of inflammation. This disease is prone to exacerbation if the immunity of the child's body is weakened. As symptoms of exacerbation, there are complaints about the presence of constant pulling pain, which increases during mechanical stress (pressure on the diseased tooth, chewing). In addition, an exacerbation of the disease is accompanied by inflammation of the lymph nodes and swelling in the area of the soft tissues of the gums, sometimes there is a deterioration in general well-being and an increase in temperature. In general, this form of the disease in children is similar to that in adults.

Chronic fibrous pulpitis

Chronic fibrous pulpitis of permanent teeth in children is as common as in milk teeth. At the same time, in teeth at the stage of resorption or formation, it often occurs with a closed tooth cavity, and in already formed teeth, with a rather thin dentin in the area of the bottom of the carious cavity. Therefore, chronic fibrous pulpitis of milk teeth does not affect permanent teeth in any way.

This form of inflammation is characterized by complaints of pain when eating. Sometimes there are pains of a aching nature after eating, which can last for hours. Depending on the prescription of the inflammatory process and the general condition of the tooth, the strength of the pain varies. Therefore, the shorter the anamnesis (duration of inflammation), the more intense and stronger the pain, and the longer it lasts, the less pronounced the pain effect and manifests itself only in the presence of external influence.

Partial pulpitis of acute type

It is rare to detect acute partial pulpitis in a 5-year-old child in milk teeth, because due to the characteristics of the organism of children, this type of inflammation becomes acute in just a few hours. It is almost impossible to notice such a process at the initial stage of development, so parents will have to pay attention to the acute form of the disease. This is due to the fact that due to the structure of milk teeth with their wide root canals and unformed roots, the outflow of exudate occurs unhindered and therefore the pain is mild.

Features of the treatment of children's pulpitis

Usually, the process of treating pulpitis of milk teeth is carried out after the development of inflammation, since it is very difficult to initially identify this disease in childhood. In addition, diagnosis is also hampered by the psychological characteristics of children who do not tolerate the examination procedure well. Therefore, in order to avoid the transition of caries of milk teeth to a further form - periodontitis, parents are advised to take their child to a specialist every 4-6 months. And if the dentist reveals pulpitis of a milk tooth, the treatment of which is required immediately, he will proceed from the symptoms and the group of teeth, choosing the right method of therapy.

How is pulpitis treated in children

In pediatric dentistry, a number of methods are used to treat inflammation of the pulp:

With its preservation: the treatment of pulpitis in children with immature roots by a non-surgical method is a process in which the root and coronal parts of the pulp remain suitable for further functioning. In this case, the method of treating pulpitis in children with iodine, as well as treatment with forphenan (with poor canal patency), can be involved. Forfenan is one of the best modern materials that has a number of necessary qualities for maximum preservation of one's own tooth - long-lasting and effective antiseptic, reliable canal filling. This paste does not shrink, and is also radiopaque, which allows you to control the quality of the filling. However, even with conservative treatment, alkaline phosphatase can be inhibited, and the deposition of replacement dentin is slowed down, which is caused by the use of outdated filling materials;
With partial amputation of the connective tissue: only the coronal pulp is removed to provide conditions for the vital activity of the root part. This method is irrelevant for temporary teeth, but it is highly recommended in case of disease of permanent teeth, since it allows you to save the root part of the pulp, which is responsible for the formation of tooth roots;
Elimination of pulpitis in children by surgical treatment: in this case, both parts of the pulp are removed at once - the root and crown, and the canals are sealed;
In some cases of advanced inflammation, a decision may be made to remove the diseased tooth.

Regardless of the method chosen, parents should remember that the treatment of pulpitis in children in one visit is not always possible, and it is worth counting on several sessions at once. At the first visit, the doctor will clean the tooth from dead tissues, put in a medical paste and close everything with a temporary filling. It is possible that the channels will be sealed already at the first visit. A permanent filling is placed only if the dentist is confident that the recurrence of inflammation is prevented.

Pulpitis in a 5-year-old child. Is it necessary to treat pulpitis in a milk tooth? Partial or complete removal of the pulp

What is pulpitis?

Forms of the disease

Symptoms of the disease

Traditional approaches to the treatment of pulpitis of temporary teeth in children

Modern methods and means of treatment of pulpitis of milk teeth

The specifics of the treatment of pulpitis of a milk tooth with unformed roots

Possible errors in treatment and how they threaten the child

How to prepare a child for treatment?

The reasons

How to recognize the problem in time?

Signs of serious dental damage

Is it worth treating milk teeth for pulpitis?

How is pulpitis treated in children?

Prevention

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Possible errors in treatment and how they threaten the child

How to prepare your child for treatment

An interesting video about the importance of treating pulpitis of milk teeth

A few more useful doctor's explanations regarding pulpitis of milk teeth

What is pulpitis?

The reasons

Symptoms

How to recognize the problem in time?

Signs of serious dental damage

Is it worth treating milk teeth for pulpitis?

Stages and methods of treatment

Traditional

Modern

The specifics of the treatment of a tooth with unformed roots

Preparation for treatment

Let's talk about the reasons

Symptoms

How to understand in time that a child has pulpitis?

If the tooth is milk, is it treated?

How is the treatment going?

How is a dental unit treated if the roots are not formed?

Preparation for therapy

Disease classification

Pulpitis of hypertrophic type

Gangrenous pulpitis: symptoms

Chronic pulpitis

Chronic fibrous pulpitis

Partial pulpitis of acute type

Features of the treatment of children's pulpitis

How is pulpitis treated in children