Is there pulpitis on milk teeth. Pulpitis of permanent teeth in childhood

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

Information about the disease

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

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

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

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

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

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

Chronic

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

The manifestation of the disease, the first sign

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

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

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

How does acute pulpitis behave?

5 years applies only to those teeth in which the root is already fully formed and until the moment when the temporary incisors begin to fall out. sharp and acute exacerbation situation with the pulp is the reaction of damaged bones to a certain irritant that has fallen into oral cavity. Accordingly, the treatment of pulpitis will begin with the neutralization of this irritant. In most cases, a similar development of events occurs between the ages of three and seven years. Therefore, at the time when they are formed, it is necessary to monitor the oral cavity of the child and no treatment of pulpitis with unformed roots not required. You need to know that single-rooted incisors are formed at the age of up to two years, and multi-rooted canines up to three.

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

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

Chronic form

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

Pulpitis therapy

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

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

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

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

Pulpitis, as the name implies, is an inflammation of the pulp. It can occur due to a violation of the method of processing teeth, for example, installing poor-quality fillings, turning teeth, surgical intervention on the periodontium. But most often this disease in a child is a consequence of neglected caries. It is carious processes that cause pulpitis of milk teeth.

Tooth pulpitis in children is much more common than in adults. This is due to the fact that milk teeth are covered with more thin layer enamel and hard tissues (dentin). At the same time, the size of the cavity where the pulp is located is quite large.

But this is not all the reasons. In milk teeth, the infection quickly passes into the pulp of the tooth due to the fact that the dentinal tubules are wide. Another feature of the course of pulpitis of milk teeth is that wide tubules contribute to the outflow of fluid (inflammatory exudate) from the pulp.

As a result, the pain may not be intense, and in some cases the inflammatory process may even be asymptomatic. Because of this, it can be difficult to determine that the disease is developing.

Symptoms that can identify pulpitis are discomfort by tapping on the teeth or chewing. The fact is that the pulp in milk teeth is massive. When it becomes inflamed, swelling begins. As a result, when the pulp is shaken, the tooth reacts with pain.

An additional factor leading to the fact that the inflammatory process develops more often in children is an insufficiently formed the immune system. The pulp in milk teeth is not as sensitive as in permanent teeth. This is another reason for the late detection of the disease.

Video: pulpitis

Forms

Pulpitis can be acute or chronic. Acute very quickly becomes chronic, and its course can be almost imperceptible either for the child or for his parents. Therefore, visiting the dentist for a preventive examination should be the norm for every family.

Acute

Acute pulpitis can be partial or general.

The main symptom of the acute form of pulpitis is recurrent pain. Moreover, it can appear without any external stimulus. The pain often occurs at night.

The following character traits acute pulpitis:

fast-flowing stage of focal pulpitis;
rapid transition of inflammation from the coronal pulp to the root;
rapid flow into a chronic form;
the transition of inflammation to the periodontium;
signs of intoxication of the body may occur: fever, headache, high ESR indicator in analyses.

Acute pulpitis in teeth with unformed roots proceeds imperceptibly, in contrast to the defeat of permanent teeth with a formed root. In the second case, the inflammatory process is accompanied by a sharp pain, and the child can accurately indicate which particular tooth hurts.

An attack of pain passes quickly and may not return soon, but this is not a reason to postpone a visit to the dentist.

With general acute pulpitis, the pain is intense and prolonged. This form is a consequence of partial pulpitis. In this case, the child cannot indicate which particular tooth hurts. The danger is that general form may be accompanied acute periodontitis, periostitis, provoke intoxication.

Chronic

The chronic form can very quickly develop from the acute form. However, more often there are cases when this form occurs primarily.

In milk teeth, fibrous pulpitis often develops, which later turns into gangrenous. As a rule, they develop with a closed cavity of the tooth.

With gangrenous there is pain from hot, putrid smell, sensation of an increase in the tooth. This form may be accompanied by periodontal inflammation, edema, characterized by painful probing.

Chronic fibrous pulpitis will be able to preventive examination detect a dentist - a small carious cavity with softened dentin is revealed. Pain from hot or cold passes quickly.

Treatment in children

Treatment of pulpitis is carried out in order to eliminate the inflammatory process, prevent periodontal diseases, create favorable conditions for the formation of permanent teeth. In pediatric dentistry, it is important that all procedures are simple, fast and deliver a minimum of discomfort.

Treatment may be conservative ( biological method) or surgery.

biological method

Photo: Conservative treatment pulpitis

This method of treatment is used for chronic fibrous pulpitis of temporary teeth. First you need to open the inflamed tooth cavity.

The pulp and the bottom of the cavity are closed with calmecin or a paste from a mixture of artificial dentin powder and Shostakovsky's balm. After drying, a filling of phosphate cement or silidont with a fluoro-cement gasket is placed.

Opinion about the use of the biological method is ambiguous. On the one hand, the preservation of the pulp will allow the tops of the roots of the teeth to form normally. On the other hand, there is information about frequent complications after the procedure.

Pulp removal

Pulp removal can be complete or partial.

Vital Methods

Vital amputation of the pulp, in other words, pulpotomy, allows you to save the viability of the root pulp, since only the coronal part of it is removed.

If the state of the pulp is incorrectly assessed - if the infected part is not removed, complications will arise after the procedure. The root pulp is protective barrier from the spread of microbes into the periapical tissues.

Pulpotomy is performed after injection anesthetic drug. The procedure can be carried out in one or two visits.

When opening the cavity, it is necessary to change the burs frequently in order to exclude infection of the deep layers of the dentin. The cavity must be washed with an antiseptic and the pulp should be cut off in the area of the canal mouth.

Adrenaline solution is used to stop bleeding. It is important to pay attention to the fact that the inability to stop bleeding may indicate inflammatory process in the root pulp. In this case, the entire pulp is removed - pulpectomy.

Vital pulp extirpation means complete removal pulp under anesthesia. During the procedure, it is necessary to exclude the possibility of periodontal damage. The use of the method is recommended for any form of pulpitis occurring in the formed teeth.

Important to pay Special attention for anesthesia. This method is not widely used in pediatric dentistry due to the complexity and length of the process.

Devital methods

The most common method of treating pulpitis of milk teeth in children is devital amputation. It is most often used in the treatment of acute general, as well as chronic fibrous forms that have developed in milk molars.

With exacerbation of chronic pulpitis and chronic gangrenous pulpitis, the method is contraindicated.

The devitalizing agent is arsenic paste. In the chronic hypertrophied form, it is applied after the elimination of the pulp and the overgrown granulation tissue.

Photo: DEVIT-ARS devitalizing paste

The procedure is under application anesthesia, for which a 3% dicaine solution, anesthesin powder and other agents can be used. The hypertrophied form requires an increase in the dose of arsenic paste, since the granulation tissue is resistant to its effects.

In the treatment of chronic fibrous pulpitis with unformed roots and in the gangrenous form, arsenic is not used. Instead, a swab is applied with a mixture of phenol and formalin in combination with an anesthetic.

In single-rooted teeth, the paste is applied for a day, in multi-rooted teeth - for two days. You need to know that prolonged exposure to arsenic paste can lead to periodontal destruction. This does not apply to special pastes, the action of which is designed for 7-14 days.

The advantage for using the method in pediatric dentistry is the absence of the need for local anesthesia.

On the second visit, the pulp is removed, and a tampon with resorcinol-formalin liquid is left in the tooth cavity for several days. The pulp is saturated with a solution of 2-4 millimeters, therefore it is not damaged germ zone unformed tooth, which contributes to further normal development roots of both milk and permanent teeth.

During the third visit, a resorcinol-formalin paste is applied to the mouth, a gasket and a seal is placed.

Particular attention should be paid to the toxicity of the materials used. During the period when the roots of milk teeth are actively resolving, it makes sense to replace the arsenic paste with a solution of phenol with anesthesin and formalin, since arsenic has a very high toxicity.

If the temporary dressing is not tightly applied, the paste can leak out and cause necrosis of the tongue, cheeks, and gum mucosa. With an overdose of the substance, acute arsenic periodontitis occurs, which requires prolonged treatment.

With acute inflammatory response periodontium in the first visit after opening the cavity, the outflow of exudate is carried out and anti-inflammatory therapy is prescribed - acetylsalicylic acid, sulfanilamides, calcium gluconate, a large number of liquids.

Devital extirpation can be used for any form of the disease. This is the most reliable way eliminate the source of inflammation.

A competent specialist plays a leading role in the fight against any disease. Parents should take the choice of clinic and dentist seriously. Violation of the treatment process of any form of pulpitis can lead to periodontitis, purulent periostitis, acute osteomyelitis.

Video: treatment

Photo:

Photos certainly do not convey painful sensations or childhood fear in front of the dentist's instruments. These are just illustrations for an article that should make parents think again that we are responsible for our children, and preventive measures much better than any treatment.

Photo: Hypertrophic pulpitis in children

Statistics have proven the fact that pulpitis occurs more often in children than in adults. This is due to the undeveloped protective function of the immune system and the structure of the milk tooth. The pulp is a soft connective tissue that fills the internal cavity. A feature of children's pulpitis is that the inflammation of the pulp occurs without pain, which makes it difficult to treat on initial stage.

Causes

The structure of milk and permanent teeth is different. In the former, the channels filled with connective tissue are wider, and the enamel coating is thinner. Because of this, the risk of pathogenic microbes entering the pulp and the development of the disease increases.

Discomfort and discomfort intensify in the evening and at night. A child with a strong immune system is characterized by an increase in temperature. To avoid the manifestation of pulpitis of milk teeth, you should know about the reasons for its appearance:

Low qualification of the dentist - during a preventive examination of the oral cavity or treatment, the doctor inflicts injury with medical devices.
Outdoor games and sports - careless movement, impact or fall damages the tooth, can chip or break part of it.
Infectious diseases - decreases during the course of the disease protective function immunity, the number of bacteria in the oral cavity increases.
Transfer of bacteria - microbes are transferred from a diseased tooth to a healthy one.
Wrong home treatment- at the first pain, you can not apply heat (for example, a heating pad), this contributes to the development of infection.
Wrong medical treatment- antiseptic preparations, filling material can cause individual intolerance and worsen the situation.
Chemical irritants - alkalis, acids, drugs that destroy the surface.

Development and classification

Pulpitis in children progresses under long-term exposure to external stimuli. There are 2 scenarios for the development of the disease:

The connective tissue of the pulp increases in size.
Dental crown is destroyed.

According to the classification, pulpitis is divided into 3 types:

Acute - part of the tooth is affected, discomfort occurs.
Chronic (fibrous) - manifests itself with a decrease in immunity.
Chronic (gangrenous) - accompanied by pain and inflammation.

In acute pulpitis of milk teeth, recurrent pain is observed, which is aggravated by eating, drinking hot, cold and sour drinks.

Features of acute pulpitis:

development is fast;
the inflammatory process penetrates from the surface into the root part;
rapid transition from the acute phase to the chronic;
the disease is accompanied by symptoms of intoxication of the body - headache, fever, lethargy and weakness.

Pain and reaction external stimuli pass quickly (the child no longer complains of discomfort in the oral cavity), and pulpitis flows into a chronic form.

Chronic fibrous form often found during routine dental check-ups. There is a small cavity with caries and softened dentin. Discomfort from food and drink is minor.

The fibrous form can develop not only in an open carious cavity, but also under a filling. In the latter case, pulpitis is manifested by constant aching pain. It can only be detected by X-ray.

Features of the gangrenous form:

putrid odor from the oral cavity (a consequence of tissue decay);
swelling of the mucosa;
the child has a feeling of an increase in the tooth and throbbing pain;
appears acute reaction when eating, eating hot and cold;
the natural whiteness of the teeth is lost;
when probing for examination at the dentist, pain is felt.

Symptoms

It is important for parents of a child of 3-7 years old to periodically inspect the oral cavity for the presence of yellow, brown spots and holes. The main period of pulpitis of milk teeth is asymptomatic. Diagnose the disease early stage difficult, the baby is not always able to explain what worries him.

Common symptoms of pulpitis of milk teeth in children:

Swelling of the mucosa around the affected area.
Enlarged lymph nodes in the neck.
Pain due to exposure to external stimuli.
Deterioration of general health (decreased appetite, apathy, sleep disturbances).

Pulpitis occurs against the background of previously untreated caries. In the acute form, the child experiences the same discomfort as an adult, so do not try to correct the situation at home using painkillers and rinses. Medications can relieve pain, but not cure the cause. Another erroneous tactic is to wait until the tooth falls out on its own. Long ignore medical assistance leads to intoxication and blood poisoning.

Treatment

Treatment of milk teeth in pediatric dentistry is based on the maximum painless procedure behind short span time.

There are 2 methods of treatment of pulpitis of milk teeth:

Conservative (biological method).
Surgical.

The main tasks of the doctor in the treatment of pulpitis of milk teeth are: the removal of the inflammatory process, the protection of the periodontium (connective tissue) and the creation of favorable conditions for the growth of permanent teeth.

At the appointment with a dentist, children often behave anxiously - they are nervous and cry. It should be borne in mind that light sedatives are used to relieve tension. Before administering painkillers, parents should inform the doctor about allergic reactions(if any) on medicinal products or their components.

conservative method used in the treatment of fibrous pulpitis. At the initial stage, the dentist opens the affected cavity. Then the bottom is covered with artificial dentin and special balm. After the hole is hammered filling material. The preservation of the connective tissue allows the upper part of the roots to form correctly in the future.

Pediatric dentists are wary of conservative method because of the risk of side effects.

Surgical method involves the complete removal of the pulp or part of it.

Removal Method:

Vital method - the coronal part is cut off, the channels retain their viability.
The devital method - the pulp and granulation tissues (connective tissue formed during the inflammatory process) are cut off, an arsenic-based paste is placed in the cavity.

The method has contraindications - it cannot be used for unformed roots, gangrenous form. In such cases, arsenic is replaced with a mixture of anesthetic, formalin and phenol, which is applied to the sore spot.

Arsenic is applied for a day, after which the pulp is removed and a filling material is inserted.

Side effects

The consequences of the treatment of pulpitis of a milk tooth:

Mechanical trauma of the periodontium with a root needle - periodontitis occurs.
Pain syndrome after amputation of the affected areas - it is recommended to replace the seal with a new one.
Toxic periodontitis appears after the application of an arsenic-based paste - the filling is removed and the treatment is performed again.

Unpleasant consequences after treatment occur against the background of the unprofessionalism of the dentist. For quality treatment it is worth contacting trusted clinics and not chasing low prices.

Prevention

A visit to the dentist is not always a pleasant experience for a child. Parents have to persuade the baby and resort to different kind subterfuge. Despite this, medical examinations twice a year are necessary, as well as other preventive measures:

teach your child to brush their teeth in the morning and evening, and rinse after each meal warm water oral cavity. For daily hygiene children should be selected soft brush And special paste;
examine your mouth once a week, pay attention to yellow and brown spots(caries), when they appear, you should consult a doctor;
in the diet of the baby there should be a set of products that strengthens the immune system, enamel and bone structure;
reduce your child's consumption of sweets and candies;
allow the child to use chewing gum immediately after eating for 10 minutes.

Formation right habits and literate eating behavior a child has a guarantee of a beautiful and healthy smile adult person.

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 deep inside the teeth. connective tissues with nerves, blood and lymph vessels. In folklore, the pulp is often simply called the dental nerve. The disease mainly affects the 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.

Pulpitis is an inflammation of the dental nerve

Causes

Most common cause pulpitis is the lack of treatment of 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 severe pain in the tooth, which usually appear 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 affected different 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. General state the baby may worsen with the appearance of fever and swollen lymph nodes.

Pulpitis of a milk tooth is accompanied by pain

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 syndrome. 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.

With pulpitis, an increase in body temperature is possible

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.

The consequences of untreated pulpitis can be very serious.

There were also deaths when an infection from an infected pulp entered the child's blood and provoked severe swelling faces.

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. However, dental treatment budget organizations and private clinics is different.

Traditional

Most pediatric dentistry 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.

Most often, in the treatment of pulpitis, a filling is installed.

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 filling them, 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 called vital amputation, the essence of which is to remove the upper part of the nerve and install it on the remaining pulp medicinal product with antiseptic and anti-inflammatory action (Pulpodent and Pulpotek materials are often used). The medicine is hermetically sealed lower part pulp, while maintaining its viability.

The specifics of the treatment of a tooth with unformed roots

Roots of milk teeth are formed long time after eruption, therefore, 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.
Top part The root zone is a "growth" zone, trauma to which will prevent root formation.
There is enough high risk infection of the rudiment of a permanent tooth.
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).
Often, a biological method is also used, the essence of which is to clean the tooth from dead tissues and lay it in it for several days. medical paste with calcium hydroxide, after which a permanent seal 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 positive effects 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 unpleasant sensations are possible, but as a result toothache 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.

Many parents have a delusion that there is no need to treat milk teeth, because after some time they will fall out and be replaced by permanent ones. Such a statement is fundamentally wrong, because if the disease is started, “adult” teeth will not form correctly, grow and become inflamed. Moreover, in children, caries quickly turns into pulpitis, so a timely visit to the dentist is simply necessary, otherwise toothaches and sleepless nights the child is provided.

What is pulpitis and what are the features of milk teeth disease?

Pulpitis is an inflammation in the neurovascular bundle, the pulp. It provokes its entry into the tooth cavity of pathogens. Often it appears as a complication of caries.

The disease is more common in children than in adults. The fact is that the dentin and enamel in children are thinner, their body often lacks calcium, due to weak immunity they are subject infectious diseases. It is quite difficult to determine that a baby has pulpitis, because the wide tubules drain fluid from the pulp. The process of the development of the disease is asymptomatic or painless, so it is important to visit pediatric dentist.

The unformed immune system of the child contributes to the fact that the process of inflammation quickly begins in the milk tooth. Causes of pulpitis include:

features of the structure of milk teeth;
caries;
infectious diseases;
mechanical, chemical, thermal damage to the enamel;
improper treatment of caries.

In children 4-5 years old, pulpitis is very common - these are the main patients of a pediatric dentist. Less commonly, they suffer from 2-3-year-old babies and children over 7 years old.

Forms of pulpitis and characteristic symptoms

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Pulpitis can be acute and chronic. At the same time, the disease passes into a permanent form quite quickly, in a few hours. This happens imperceptibly, asymptomatically, the baby is not bothered by anything or he cannot adequately express his complaints. The fact is that in temporary teeth there are still unformed roots, and damage to bone units does not give such an acute painful reaction.

The child may sometimes be disturbed by a slight pain during chewing and at night. acute form is rare, mostly pediatric dentists diagnose chronic pulpitis.

Acute form of the disease

Symptoms of acute pulpitis:

periodic pain in the tooth without a visible irritant, more often at night;
pain when tapping on a damaged tooth;
swelling of the gums;
fever, general intoxication;
enlarged lymph nodes;
loss of appetite;
sleep disturbance;
headache.

Pulpitis in milk teeth acute phase

With the defeat of milk teeth, the pain is not as sharp as in an adult. Often children cannot determine in which place they appear pain. They say that all the teeth hurt at once.

Attacks of pain can be repeated at significant intervals, therefore, at the first symptoms of pulpitis, it is important to visit a pediatric dentist. If you start the disease, it will turn into general acute pulpitis. It, in turn, is complicated by acute periodontitis, periostitis, significant intoxication of the body.

It is not recommended to give painkillers without consulting a specialist. You can only alleviate the condition of a sick baby and immediately apply for dental care. Also, do not do warm compresses, because with purulent pulpitis they will only aggravate the situation and increase the amount of pus.

Chronic form

The chronic form of pulpitis can also be primary, that is, it does not follow from acute condition. This happens when the cavity of the tooth is closed. Chronic pulpitis is divided into:

fibrous - a carious cavity forms on the tooth, a quickly passing pain from hot, cold and sweet appears;
gangrenous - occurs at the site of fibrous pulpitis and manifests itself as pain upon contact with hot food and drinks, smell of rot, swelling and feeling of swelling, enlargement of the tooth.

Infectious chronic pulpitis in a child

When you press on a damaged tooth, the pain intensifies. On examination, a pediatric dentist will notice a darkening of the enamel. Often there is an increase in lymph nodes, as general reaction body for inflammation.

Pulpitis of permanent teeth in a child

With the defeat of permanent teeth and their roots, pulpitis in children proceeds with all the "adult" symptoms. Diagnosing it is easier because at this age, children can already describe what is bothering them. Thus, it is possible to detect the disease at an early stage.

Signs by which pulpitis can be determined in children:

mild pain for no reason;
gradually develops pain that occurs when irritated by cold or hot;
the intensity of the pain increases at night;
pain is given to the temple, the back of the head under the orbit.

When pulpitis becomes chronic, discomfort occurs intermittently, then disappears. You need to pay attention to this condition in time.

Applied methods of therapy and stages of treatment of pulpitis

If caries or pulpitis is suspected, the child should be shown to a pediatric dentist. The doctor diagnoses the disease and determines the treatment strategy. Will be assigned as needed additional research– radiography, electroodontodiagnostics (EDI).

The treatment of milk teeth with unformed roots differs from the treatment of an adult, so it is better to contact a proven, competent specialist. Folk remedies and self-medication in the treatment of pulpitis will not help, they will only delay the start of therapy and contribute to the complication of the disease.

Biological method of therapy

This method is used for chronic fibrous pulpitis of milk teeth. The cavity is opened, calmecin or a paste from a mixture of artificial dentin powder and Shostakovsky's balm is placed in it. After that, a filling of phosphate cement or silidont with a fluoro-cement gasket will be placed.

Devital treatment

Devital amputation is the most commonly used. It is indicated for general acute and fibrous pulpitis. With an exacerbation of a chronic disease and a gangrenous form, such treatment cannot be carried out.

The whole procedure takes place under anesthesia, it is carried out in several stages. First, an arsenic paste is applied. You can keep it for a short time, with the exception of those pastes that are designed for a period of 1-2 weeks.

Upon repeated admission, the pulp is removed and a swab with resorcinol-formalin liquid is left for several days. On the third visit, the dentist will apply a resorcinol-formalin paste, a pad and place a filling.

This method allows the roots of milk, and after and permanent teeth, to develop normally. Unqualified treatment can be aggravated by complications that lead not only to tooth loss, but also seriously threaten health. That is why you should choose a pediatric dentist with all responsibility.

Amputation treatment of pulpitis

Pulp amputation takes several visits to the dentist. When the diseased pulp is removed, the tooth ceases to receive nutrition. For this procedure, you will need to put anesthesia on the child.

Experts try not to use this method, because it is painful, difficult and time consuming. Nevertheless, the emphasis is on preserving, curing the diseased pulp.

Complications after treatment

Improper treatment of pulpitis of milk teeth or failure to consult a specialist leads to damage to the rudiment of a permanent tooth.

The removal of a milk tooth leads to pathological formation teeth not only in its place, but also adjacent to it (more details in the article:). It is usually possible to save a tooth even in complex and advanced cases, although children are much more difficult to treat than adults. Small patients do not want to sit in a chair and often interfere with the treatment.

Only 5-7 days are given for post-filling pain after pulpitis treatment. If the child still has a toothache, it is necessary to visit the dentist, otherwise you can miss the development of complications.

TO serious complications running pulpitis can be attributed to:

periostitis - better known as flux;
periodontitis - the formation of fistulas on the gums;
lymphadenitis - inflammation lymph nodes(we recommend reading:);
osteomyelitis - overgrowth purulent process in the jaw regions;
abscess and phlegmon - the transition of inflammation into the space between the muscles;
blood poisoning, sepsis, and eventually death.