Does pulpitis of baby teeth need to be treated? What is usually prescribed to relieve pain symptoms?

Diseases of primary teeth in children are not harmless problem, contrary to most parents. Without proper treatment, they lead to disturbances in the formation and growth of molars. Pulpitis in children is the most common disease resulting from specific features structure of children's teeth. Next, we will consider how pulpitis manifests itself, why it occurs, what forms it has and methods of treating young patients.

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

The localization of the disease in the mouth may vary, but in most cases the disease affects lower teeth and molars. The front teeth are less likely to suffer. Advanced pulpitis can lead to complications such as periodontitis or periostitis. IN childhood similar complications progress much faster than in an adult, even within a day. There are cases where in just a couple of days of development acute form Pulpitis in the child resulted in blood poisoning, which ended in death. Important task parents - to detect and treat caries in their children in time.

Causes

Baby teeth are more susceptible to disease than molars, and the special structure of primary teeth is to blame. Their enamel is thinner, dentin is not strong, and the pulp chamber is wider. The dentinal tubules of baby teeth are wide and short, as a result of which the inflammatory process spreads quickly. Immune protection child's body is not fully formed, which prevents him from fighting infection as effectively as an adult; the result is that infectious and inflammatory diseases are so common in childhood.

Factors that increase risk:

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

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

Photos

Kinds

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

Spicy

Serous stage. The canals fill with serous fluid and the pulp becomes inflamed. The first pain often comes at night, and during the day it manifests itself in temporary attacks during chewing. After 5 hours the next stage begins.
Purulent stage. Characterized by the formation and accumulation of pus in the canals. If the child strong immunity, then there may be no unpleasant sensations, and the pus will come out through the cavity destroyed by caries. But most often purulent acute pulpitis manifests itself long-term pain. The child cannot say exactly where it hurts, because the pain radiates to nearby teeth. Lymph nodes and body temperature may increase. Most parents take their children to the dentist.

Chronic

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

Gangrenous inflammation can be recognized by the absence of sharp pain immediately after eating hot or cold food; after a while, a nagging sensation appears toothache. With this form of pulpitis, the child develops bad smell from the mouth, sometimes the baby feels heaviness or bloating in the area of the affected tooth. Swelling and inflammation of the periodontium may occur.
Chronic fibrous pulpitis, like gangrenous, is the primary stage of the disease. It is detected during an 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 painful sensations disappear as quickly 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.
Hypertrophic appearance The disease is characterized by the growth of the pulp, existing crowns are often destroyed, and 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 detect the disease in time. But most often for the presence of problems in oral cavity indicate the following signals:

temperature increase;
inflamed tissue around the tooth;
painful reaction to hot or cold food;
putrid smell from mouth;
inflammation of the lymph nodes;
swelling.

Signs of the disease can occur separately or appear together. In any case, you need to immediately show the child to the doctor.

Diagnostics

After visiting a pediatric dentist, the child must undergo a number of mandatory procedures to assess the condition of the oral cavity and choose a strategy for the treatment process.

Don’t delay going to the doctor and getting examined

A general survey of parents and the child about when the pain began, how severe it is, and what is the frequency of occurrence.
Examination of the mouth, facial contours and lymph nodes.
Directed dental diagnostics. The condition and thickness of dentin and gums, the reaction of teeth to irritants, and the severity of swelling (if any) are assessed.
If necessary, the child is sent for a dental x-ray or EDI.

After full diagnostics The baby is prescribed appropriate treatment.

Treatment

The choice of treatment method is influenced by the child’s age, his individual characteristics, the condition of the root canals, as well as the nature of the pulp damage. There are traditional and modern methods treatment of pulpitis in children, which differ not only in the materials used, but also in the technique of implementation.

In any case, the dentist's goal is to avoid the removal of baby teeth if possible, but sometimes it is still necessary.

Traditional methods

In regular children's clinics, you will most likely be offered the method of non-vital amputation. It involves working in several stages.

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

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

The process of treating the disease: drilling, cleaning canals, filling

Modern approach

If the roots of the teeth are sufficiently formed and the child can withstand long-term manipulation, then it is recommended to use devital or vital extirpation. Such methods require 2-3 visits to the dentist.

The difference lies in the first stage of preparation. During vital extirpation, the canals are immediately freed from the nerve, and the devitalizing procedure begins with the installation of a devitalizing paste on the exposed pulp. It gradually kills the nerve. Next, according to the standard scheme, the canals are mechanically cleaned and treated with medication. The next step is to remove the damaged pulp and place the paste into the sterile canal. Use zinc eugenol paste or foreign analogues. Distinctive feature pastes used in work using such methods is the possibility of their resorption along with the roots when the teeth are replaced with molars.

Another effective one modern way which allows you to cure tooth pulpitis is vital pulpotomy. Its task is to leave the entire contents of the tooth, or at least part of it, in a viable state. Upper part 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 immature roots

When a baby's primary teeth erupt, the tops of their roots remain uncovered for some time. The described condition of baby 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 precision and care from the specialist, since the slightest mistakes with antiseptics will lead to repeated pain. In addition, it has enough contraindications.

The biological treatment method involves maintaining the vitality of the pulp. Thus, it continues to supply the tooth tissue with nutrients. Painful sensations are blocked by anesthesia, the carious cavity is cleared of infected tissue, and the hole or bottom of the cavity is treated medicinal paste. After a few days, the pain goes away 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 removing the affected pulp from the teeth. Almost all drugs can be used for manipulation: from resorcinol-formalin to Pulpotek or Pulpodent.

You need to understand that during devital amputation the pulp is completely killed. In addition, potent toxic pastes may be used. Over time, after such manipulations, the tooth begins to crumble and break off.

Mistakes and Consequences

Due to their fragile psyche and unconscious resistance, children often prevent the dentist from carrying out the procedure according to all the rules. Fear of visiting a doctor, the unknown and painful sensations are perceived by the child as torture, not help. For restless children, devital amputation is performed with resorcinol-formalin (this allows the tooth to be somehow cured).

Children often get burns on their gums due to paste getting there. As a result of such mistakes, the pain intensifies, the child is sent for another appointment, the work is done again, and wound-healing gels are prescribed.

Treatment of children with unformed roots is characterized by the risk of bleeding due to the efforts made by the doctor during cleaning of the canals. The needle injures the tissue, and it is quite difficult to stop the bleeding, even using hemostatic drugs.

Inexperienced dentists sometimes encounter problems such as part breaking off dental instrument in the canal of the teeth or perforation of the root. Risks serious tissue inflammation. 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, then most often with the help of drugs they simply mummify the canal.

Preparation

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

Parents' tasks before visiting a pediatric dentist:

Tell your child that bad teeth can be cured and the pain will go away.
explain that the usual procedure awaits them, all children and adults go to the doctor to treat their teeth if they start to hurt;
Do not intimidate the child under any circumstances and do not tell horror stories about doctors;
Do not deceive the baby that there will be no pain. It’s better to say: “Yes, it will be unpleasant, but after treatment your teeth will stop hurting”;
keep calm, first of all, to the parents themselves;
You can show in a playful way how manipulations are carried out, and let the child do them himself with family members;
Bring your favorite toy to your appointment. If the baby wants, let him hold it in his hands;
choose a time when the child feels well, has slept and eaten;
If the baby flatly refuses and becomes hysterical, don’t force it, it’s better to reschedule the session for another day.

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

Prevention

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

In addition, to prevent caries from occurring on your child’s teeth, his body needs all the minerals necessary for teeth. Limit the consumption of sugary foods, give only water before bed and teach your child to brush their teeth daily.

Pediatric dentistry is a separate medical branch, where the doctor’s professionalism must be combined with knowledge of the psychology of children. All dental diseases are curable, the main thing is that the little patient allows the manipulations to be performed correctly. Baby teeth are always treated, because pulling them out is dangerous for the formation of a correct bite.

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

Summary

Treatment of baby teeth is a mandatory procedure, neglect of which leads to serious complications, long recovery and even fatal outcome. In order not to give the disease a single chance, you need to promptly consult a doctor and undergo dental examinations. Children's clinics practice several methods of treating pulpitis, talk to your doctor and choose suitable option. The hope that the disease will go away while changing teeth is groundless. This attitude can damage the main teeth, which will remain for life. Monitor the baby’s condition, pay attention to complaints and immediately take him to the doctor. In the case of health, it is better to be safe than to miss the moment.

Much more often than in adults, pulpitis of baby teeth occurs in children. We will provide further symptoms, treatment, photos and explain in detail all the nuances of this disease. We will talk about what it is, whether it needs to be treated and how dangerous it is to ignore the problem in this article.

Structure baby tooth slightly different from an adult, permanent one, therefore the diseases have their own characteristics, 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 aware of the following nuances.

What is the peculiarity of pulpitis of a baby tooth?

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

A thin layer of enamel and a small volume of dentin practically do not protect inner part from the aggressive effects of bacteria.
An enlarged pulp that occupies more space and is much easier for pathogens to reach.
Wide dentinal tubules contribute to the rapid spread of the disease.
Good drainage of fluid from inflamed areas significantly reduces pain and makes it impossible to detect the problem.

Because of these differences, parents do not always find out in time that active processes of tooth decay are occurring in the child’s mouth. Therefore, it is worth paying attention to any complaints, even the most insignificant ones, that the baby tries to express. Then the diagnosis in the dentist’s office will be carried out on time.

Don't think that similar problem affected only the child who did not brush his teeth well 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.

Whatever the reason, pulpitis develops too quickly and manifests itself poorly. Therefore, you should pay attention to the child’s complaints immediately and visit a doctor on time.

Symptoms and forms of the disease

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

Acute pulpitis, which, in turn, can be:

Focal, that is, partial.
Diffuse or general.

Chronic, which also has its own varieties:

Fibrous.
Gangrenous.
Hypertrophic.

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

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

If the pain periodically appears and disappears, then this is most likely partial pulpitis. When it is long-lasting, intense and the child cannot indicate which 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 develop into periodontitis and end in general intoxication of the body.

The stages of the disease do not always pass 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:

In the fibrotic stage, the symptoms of the disease are less pronounced, and the entire process takes place in a closed cavity.

Photo

Treatment of pulpitis in children

The most important thing in the treatment process is to eliminate direct inflammation, remove the pulp or part of it and prevent the development of possible complications. If you do not pay due attention to this, then in addition to more serious complications in surrounding tissues, future ones may also be damaged permanent teeth, which will form incorrectly due to this problem.

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 treating pulpitis, it can be calamus, hydrogen peroxide, lemon and various medicinal herbs. And yet, it is not worth conducting experiments and risking the child’s health. Contact a doctor who will make an accurate diagnosis and perform the necessary manipulations.

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

biological;
amputation;
devital.

We will tell you about each of them in more detail.

Biological method

This is normal conservative method and it is considered traditional in pediatric dentistry. No serious ones surgical interventions this does not happen. The doctor carefully opens the inflamed pulp and fills it with a special mixture of Shostakovsky balsam and artificial dentin. In some cases, calmecin is used. After this substance has dried, the usual filling is carried out.

But modern young doctors are increasingly refusing similar treatment, since it is fraught with complications, a long recovery process, unnecessary intervention and the possibility of inflammation spreading to the periodontium.

Amputation

Some clinics will immediately offer complete removal pulp or parts thereof. Of course, this 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 only the coronal part is affected. In this case, the root remains to protect the periapical tissues from various pathogens. In cases where 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:

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

When it comes to pulpectomy, that is, complete removal of the pulp, you need to be especially careful to carry out the procedure so as not to damage the periodontal tissue. They try not to use this method everywhere, as it is painful, complex and time-consuming. However, the doctor 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 of arsenic paste and local anesthetics are usually used. But for the gangrenous form, it is recommended to use formalin and phenol. Next, depending on the selected product, it is left in the child’s dental cavity for 1-2 days or 7-14 days. The decision on the duration of this stage is made by the doctor based on clear instructions for a specific drug.

And 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 open cavity filling. In order to evoke pleasant emotions in a 4-5 year old child from such long-term 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 performed carefully and gently, without stress for the child. It is also very important that painkillers and safe substances are used. Increasingly, pediatric dentists prefer this method of treating pulpitis in children. different ages. It can be used for almost any form of disease.

Complications

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

Initially incorrect diagnosis. And if the dentist removed only part of the inflamed pulp, the remaining source of infection will continue to destroy healthy tissue.
Too little application of arsenic paste leads to its leakage. If it gets on the mucous membrane, the medicine will quickly cause necrosis, affecting the inside of the cheek, tongue and gums.
If there was too much arsenic or it was used when the roots of a baby tooth began to be reabsorbed, then poisoning and intoxication of the child’s body is possible.
But it is not recommended to pack the medicine too tightly. After all, then you can provoke a burn of the mucous membrane.
Careless actions of a doctor can lead to the development of disease in a healthy part of the tooth or soft tissues under him. For example, if the dentist caught the periodontium with a needle during treatment.

Failure to follow the rules can also cause complications. The most serious consequences of pulpitis are periostitis and even acute polio. Therefore, you should contact a pediatric dentist in time and carry out the necessary manipulations, despite the cost of treatment and the fact that baby teeth are temporary units.

Prevention

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

Video: pulpitis of baby teeth in children.

Additional questions

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

Painful sensations may be associated with medical intervention and tissue irritation from medications. If the pain itself subsides over time, then this normal reaction body. If it appears after treatment and its intensity does not subside, you should consult a doctor, since perhaps the procedure was performed incorrectly and something needs to be corrected.

The child’s temperature rose after treatment for pulpitis

An elevated temperature in a child may be a simple reaction to stressful situation. And yet, ignore similar symptom It’s not worth it, as most often this can indicate a serious inflammatory process. You should immediately consult a doctor and re-diagnosis.

Pulpitis is a disease of dental tissues that differs inflammatory in nature. It usually develops against the background improper treatment. Not only adults, but also children have to deal with this pathology. From the materials in this article you will learn the causes of the disease, as well as its forms and the main methods of treatment.

Tooth pulpitis - what is it?

The pulp is the neurovascular bundle of the tooth. As a result of the penetration of pathogenic microorganisms into this area, an inflammatory process develops. The disease often occurs as a complication of caries or is a consequence of improper treatment ( low quality fillings, periodontal surgery, tooth grinding).

Pulpitis is one of the most frequent complaints patients dental clinics and at the same time it is considered a fairly common disease of primary teeth. In this article we will dwell in more detail on the manifestations of this disease in young patients, we will talk about the most effective methods treatment.

How is pulpitis different in children?

Pulpitis of primary teeth in children is a fairly common pathology. Its timely treatment helps prevent the development of dangerous complications.

Children are several times more likely than adults. Experts explain this phenomenon by the characteristics of babies. They have connective tissues differ in friability, root canals wider, and the dentin itself is less mineralized.

The imperfection of the immune system also leaves its mark. The likelihood of catching a cold as a child is several times higher than as an adult. Nature has managed to balance this nuisance by the fact that the disease in 65% of cases is practically asymptomatic. This is what is hidden main danger illness.

If your child often complains of toothache or the enamel has become overly sensitive to hot/cold food, you should visit a dentist. You should not postpone your visit, because the consequences of this disease are unpredictable. Some note that after pulpitis the tooth hurts even more, while others experience severe swelling and a cyst forms.

Main causes of pathology

The disease usually develops under the influence of negative factors such as of a singular nature, and in total:

Exposure to toxins released pathogenic microorganisms in a carious cavity.
Mechanical damage to the tooth, careless treatment of the oral cavity, nerve damage during surgical procedures.
Previously rescheduled acute illness accompanied by decreased immunity.
Treatment of teeth with antiseptics with an aggressive formula.

Choice effective therapy directly depends on the reasons that caused tooth pulpitis in a child. Treatment in most cases allows you to save the molars.

The complexity of therapy for this disease comes down to the fact that the doctor can only eliminate that fragment of the pulp that is located directly in the crown. Its root part is subject to mandatory deletion only in fully formed dental roots. This is very difficult in young patients due to high risk traumatization of soft tissues and rudiments of permanent incisors.

What are the symptoms of pulpitis?

Clinical picture pathologies are striking in their diversity. There are patients with no complaints and cases where symptoms of the disease are clearly manifested (painful discomfort, intoxication of the body, periostitis).

It is very difficult to diagnose pulpitis in a timely manner, because young patients cannot always accurately state their complaints. Therefore, parents often miss the onset of the disease and bring the child to the doctor with an acute form.

Among the main symptoms that occur with pulpitis are the following:

paroxysmal pain;
lymphadenitis;
swelling of the tissues around the tooth;
general deterioration of the child's condition.

The manifestation of specific signs of the disease depends on its form. Next, we will talk about each variant of pulpitis in more detail.

Hypertrophic pulpitis of the tooth

What it is? This form of the disease is extremely rare in children. It is characterized complete destruction tooth crown and the growth of pulp tissue. When probing the affected area, bleeding appears. The child usually does not feel pain. Minor discomfort occurs only when chewing food.

Gangrenous pulpitis

This form of the disease develops against the background of diffuse pulpitis. Little patient practically does not feel discomfort in the oral cavity, but upon examination darkening of the tooth enamel is observed. A clear sign The pathological process is a peculiar smell from the mouth associated with the destruction of the pulp and its interaction with pathogenic microflora. Lymph nodes may be enlarged, but remain painless.

in the acute stage

The exacerbation of the disease is caused by problematic outflow of exudate and weakened immunity. The child complains of constant toothache. Lymph nodes enlarge as the disease progresses, and the tissues of the affected area swell. The disease can only be detected using an x-ray, which usually shows destructive changes at the apex of the root.

Chronic pulpitis

When protective forces the body weakens, and chronic tooth pulpitis usually worsens. What is this, what kind of pathology? Symptoms of the disease are the child’s complaints about nagging pain, which intensifies during meals. In addition, the tissues surrounding the tooth become inflamed and swollen, and the lymph nodes increase in size. Sometimes chronic form accompanied by fever and deterioration general condition child.

Acute partial pulpitis

In children with baby teeth this form the disease is very rare. It is not possible to detect the disease in a timely manner.

Diagnosis of the disease

Modern medicine offers several options for identifying dental disease. Pulpitis can be detected during a dental examination. During the examination it is necessary Special attention pay attention to tooth mobility and sensitivity. For determining accurate diagnosis X-rays are taken and the teeth are checked for sensitivity to cold/hot temperatures. Based on the examination results, the doctor confirms pulpitis in children’s primary teeth. Treatment of the disease is selected on an individual basis.

What should the therapy be like?

Treatment should be aimed at eliminating inflammation, preventing the development of periodontitis, creating the maximum favorable conditions for the growth of permanent teeth. In pediatric dentistry, it is extremely important that all manipulations are simple and at the same time painless.

How is tooth pulpitis treated? Therapy can be either conservative (biological method) or surgical. The choice of a specific treatment option depends on the severity of the pathology and its form.

Biological method

This method of treatment is used for chronic fibrous pulpitis of primary teeth. Initially, the doctor opens the inflamed cavity. He applies a paste made from a mixture of artificial dentin and Shostakovsky balsam to its bottom and the pulp itself. The affected area is then dried and a phosphate cement filling is placed.

Opinions about use biological method treatments differ. On the one hand, saving the pulp allows the root tips to fully form in the future. On the other hand, after treatment of pulpitis, the tooth often aches and hurts.

Surgical method

The surgical treatment option involves complete or partial removal of the inflamed pulp. Manipulations can be carried out in two ways:

Vital method. During the procedure, the doctor removes the coronal part of the pulp, while the root part is preserved. When, as a result of improper treatment, an infected fragment remains, the likelihood of complications increases (the tooth after pulpitis may hurt, and the surrounding tissues may swell). The root pulp does not allow pathogenic flora to penetrate the periapical tissue. To avoid opening the cavity, it is necessary to change burs as often as possible. At the final stage, the affected area is washed antiseptic solution. The pulp is cut off at the mouth of the canal, and the bleeding is stopped with a regular solution of adrenaline.
Devital method involves the use of arsenic paste, which is applied immediately after pulp removal. During manipulations, the doctor usually uses arsenic and leaves it for 1-2 days. Long-term use pastes can destroy periodontal tissue. At the next consultation, the pulp is removed, and a tampon soaked in a special liquid is placed into the cavity. During the third visit, the doctor installs a filling.

The devital method of treatment today is most often used for acute or chronic course diseases. In this case, it is strictly contraindicated.

Let's sum it up

In this article we talked about why tooth pulpitis develops, what it is and what its symptoms are. primary symptoms. Treating this disease is not an easy task, especially for pediatrician. The specialist must not only eliminate pathological process, but also maintain the opportunity for the full development of permanent teeth in the future. Pediatric dentistry has a number of features and differs significantly from adult dentistry.

For those children and their parents who regularly visit the dentist’s office together, it is not difficult to detect pulpitis in a timely manner and take action. necessary measures for his treatment. If you notice a damaged or discolored tooth, you should immediately visit the dentist. Otherwise, the likelihood of developing a complicated infectious process increases.

As a preventative measure, it is recommended to visit the dentist twice a year. Caries detected in time helps prevent pulpitis in children's primary teeth. It is better to start treatment of this disease in the initial stages of development. Be healthy!

Pulpitis, or inflammation of the pulp, often occurs in children as a complication of caries. Moreover, in children it develops more rapidly than in adults. Within just a few weeks, periodontitis, granuloma or other diseases may occur in which it is impossible to save the tooth.

Causes of pulpitis in children

The main cause of the disease is an infection that penetrates into the pulp from a deep carious lesion. Streptococci, staphylococci and others pathogenic bacteria enter the pulp chamber through a thin dentinal layer. They release toxins and cause an inflammatory process that affects the upper (coronal) part of the pulp and dental canals.

Other causes of the disease:

chips, cracks, fracture of the dental crown (traumatic pulpitis);
installation of low-quality dental filling;
exposure to concentrated acid or antiseptic when dental treatment;
infection through the root apex (retrograde pulpitis).

Features of pulpitis of milk teeth

Pulpitis in baby teeth is diagnosed more often than in permanent teeth. It's all about anatomical structure temporary tooth:

An additional contributing factor rapid development pulpitis - weak the immune system a child who is not yet able to cope with an infection in the mouth.

Symptoms of pulpitis in a child

The danger of childhood pulpitis is that in 65% of cases it is practically asymptomatic. This is explained by the fact that the pulp in children is less sensitive than in adults. The clinical picture is always individual character and is distinguished by a variety of symptoms: from bright severe symptoms before complete absence complaints.

Main signs of the disease:

mild or intense toothache that occurs spontaneously and intensifies at night;
pain when pressing on the tooth, for example, while eating;
sensitivity to cold and hot;
swelling of the mucous membrane;
increase in body temperature to 37-38 degrees;
inflammation of local lymph nodes (late stage).

Classification of childhood pulpitis

Spicy

This form of the disease is rare in children, but manifests itself aggressively. Severe, radiating pain occurs spontaneously or after mechanical impact per tooth The baby's sleep and appetite worsen.

Chronic

It can develop even with shallow caries. It is painless with rare exacerbations when immunity is low, for example, during a cold or during the off-season. Then a nagging toothache occurs, which increases when you press on the tooth.

Fibrous

It is characterized by the proliferation of connective pulp tissue, which can extend beyond the boundaries of the carious cavity. Sharp pain begins after eating and lasts several hours. It occurs as a transition of pulpitis from the acute to the chronic stage.

Hypertrophic

It is extremely rare in children. Develops against the background of neglected chronic inflammation pulp. The crown of the tooth is usually completely destroyed, but there is no pain. When probing the pulp bleeds.

Gangrenous

Late stage, in which the diseased tooth begins to darken. Due to the decay of the pulp, an unpleasant putrid odor occurs from the mouth. A purulent fistula often forms on the gum. There is little or no pain.

Prevention of pulpitis in children

The basis for the prevention of pulpitis of primary teeth is timely treatment caries. Parents should understand that temporary teeth need the same quality treatment, as well as constants.

Also, do not forget about regular preventive examinations with a pediatric dentist; they should be done every 4-6 months. It is important to teach your child all the nuances of home hygiene care behind the oral cavity.

Remember that inflammation can move from the pulp to the deeper tissues of the oral cavity (periodontal or periosteum). This threatens to infect the buds of permanent teeth. Besides, long course disease can provoke the development of cystic formation.

Therefore, do not delay visiting your doctor. You will find a list of pediatric dentists on this page below.

Parents quite often do not pay enough attention to their children’s baby teeth. It is generally accepted that temporary teeth do not require care and, moreover, there is no need to treat them. In fact, children experience pulpitis of a baby tooth, which requires compulsory treatment. Otherwise, there is no guarantee that negative consequences will not occur.

What is pulpitis

Pulpitis refers to a dental disease affecting the pulp body. This is a bundle of nerve, blood, and lymphatic vascular endings that are located in the root canals or in the root region of the tooth.

In most cases, the disease develops in the lower teeth, since children still have quite fragile dentin, which is not able to properly protect the baby’s teeth from pathogenic bacteria.

Pulpitis in children

Causes

Before starting treatment for pulpitis of baby teeth, it is necessary to understand what caused the disease. By excluding negative factor and having treated the disease, you don’t have to worry about your child’s teeth in the future. The most common reasons include:

The cause of the development of the disease can be an enlarged pulp, which is quite easy for pathological microorganisms to reach.
Due to the insignificant coverage of the tooth with enamel, high-quality protection of the oral cavity does not occur.
If wide dentinal tubules are diagnosed, this may affect the rapid spread of the disease.
Damage to a tooth during preventive examination due to the low qualifications of the dentist.
Infectious diseases contribute to the proliferation of bacteria in the oral cavity.
Self-medication when a child is given warm heating pad or make warm compresses.
Intolerance to filling materials.
Damage to the enamel surface due to intake medicines, sour and spicy foods.
The cause is caries that was not treated in a timely manner.

Pulpitis develops very quickly and on initial stage may not cause pronounced symptoms. Therefore, it is necessary to consult a doctor in a timely manner if the child complains of pain and discomfort in the oral cavity.

IMPORTANT:Only pediatric dentist decides to treat or remove pulpitis of a baby tooth

Symptoms

Even if no symptoms of the disease are observed, the child’s visits to the dentist should be regular. With pulpitis, symptoms can be varied. It all depends on the course of the disease. Pulpitis is characterized by 2 stages of development.

Development of pulpitis

1. Serous stage

After the onset of the inflammatory process, the canals are filled with serous fluid. During this period, very severe pain appears, which is most pronounced during meals or at night. Painful sensations may appear several times. If no measures are taken, then after 6 hours the disease will move to another stage.

2. Purulent stage

It is with this form of the disease that the child is brought to the dentist, since the signs of pulpitis are very pronounced.

It begins to accumulate in the canals of baby teeth. purulent fluid, which exits through the cavity of a tooth damaged by caries.
The child experiences very severe pain, which is long-lasting.
The pain may disappear for a while and then appear again.
The child also complains that all his teeth hurt. This is associated with severe pain.
The baby stops eating.
The pain is so severe that it is impossible to even touch the tooth.
Sometimes there is an increase in temperature.
Depending on the severity of the disease, the lymph nodes in children become enlarged.
There is an unpleasant odor from the mouth.
The tissue around the diseased baby tooth becomes inflamed.
Feeling of expansion and heaviness in the tooth.

IMPORTANT:In children under 2 years of age, such symptoms may not be observed, since at this age the roots have not yet fully formed.

Preparing for treatment

If pulpitis is diagnosed in children's primary teeth, treatment is carried out only in dental clinic. Self-medication is prohibited. It is very important to prepare your baby in advance for a visit to the doctor. Almost all children experience fear of dental treatment. Therefore, parents should take the issue of preparation seriously.

You can tell your child who a dentist is and why he treats teeth.
Talk about the consequences if you do not undergo treatment.
Do not frighten your child with pain or discuss it negative points during treatment.
Parents should not worry so as not to provoke fear in the baby.
You can take your favorite toy to the doctor.
If the child does not allow the examination, postpone the treatment procedure for another day.

Tooth structure

How to treat pulpitis of baby teeth in children

Treatment of pulpitis in children's primary teeth has stages that involve various ways in the fight against pulpitis. And only the doctor decides which method will be used.

Traditional method

A child with this type of treatment must visit the dentist several times. The procedure algorithm is as follows:

The inflamed pulp is carefully opened.
It is filled with a paste containing Shostakovsky balm and natural dentin.
The paste should remain in the pulp for 1-2 days.
If arsenic is added, keep this mixture for a week.
At the next visit, the tooth is filled.

Amputation method

This method consists of removing the pulp or a certain part of it. Because the procedure for removing the entire pulp is painful, the pediatric dentist may use local anesthesia. With partial removal, only the coronal part is affected. The root remains so that the tooth is protected from the penetration of pathogenic bacteria.

There are several rules that the doctor always adheres to:

To prevent infection of deep tissues, only sterile tips are used.
Before removal, the tooth area must be treated with a high-quality antiseptic.
To stop the bleeding after removal, the required doses of adrenaline are selected individually.

Devital method

Parents will be interested to know how pulpitis of baby teeth in children is treated in other ways. This method involves the complete removal of inflamed tissue from baby teeth. Treatment consists of several stages. At each stage, the doctor uses a specific dose of the drug to kill the infected tissue. Most often, arsenic paste is used for this.

The paste is left in the mouth for a minimum of 1 day and a maximum of 7.
After a while, the cavity is cleaned.
Place a tampon with medicinal mixture so that all healthy tissues are saturated with the resorcinol-formalin mixture.
These substances promote the growth of permanent and healthy incisors when baby teeth are replaced.
At the third stage, the tooth is filled.

IMPORTANT:To eliminate stress in a child, use safe painkillers.

Prevention

It is possible to avoid pulpitis in a child if I follow preventive measures.

To exclude in the oral cavity inflammatory processes, With early age It is necessary to accustom the child to oral hygiene. Children should brush their teeth regularly every morning and before bed.
Parents should only buy children's toothpastes.
Important It also has baby food. It is necessary to minimize the consumption of sweets, chocolate, and baked goods.
For prevention purposes, it is recommended to take courses of vitamin preparations.