Does pulpitis occur on baby teeth? Pulpitis of permanent teeth in childhood

By its nature it is severe inflammation hard tissues inside and outside the bone. Typically, pulpitis develops as a complication of advanced caries. In some cases, the disease develops independently, but this happens only after serious maxillofacial trauma. Inflammation develops according to in different ways– chronic or acute. But today we are interested in how this disease is tolerated by a baby 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 exposed to toxins that are released by microbes in the carious cavity of the affected incisors;
Serious injuries that provoke childhood pulpitis. These include careless treatment of teeth by doctors, opening of nerves;
An infectious disease due to which the child loses a stable state of immunity;
Wrong choice of filling material that is not suitable for the bone type. Dairy demands special means and materials, in addition, some may have pathological allergies;
Overheating of oral tissues during caries preparation without cooling with water or air.

Pulpitis of primary teeth develops quite often, usually at the age of about 2 years. Disease of the molars, which grow closer to the throat, appears at the age of 3 years until they are replaced with permanent ones.

According to statistics, children require treatment for molars five times more often than for canines and incisors. In addition, the incisors lower jaw are affected more often and faster than the upper one.

Now let’s look at what the classification of pulpitis in children looks like:

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

Chronic

This classification can also be given by the doctor who will examine the child, so it is better to familiarize yourself with it immediately.

Manifestation of the disease, first sign

Pulpitis of baby 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 allocate them to a person without medical education difficult. We will look in detail at how childhood pulpitis develops and how pulpitis in children is treated.

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

The disease can develop in the oral cavity, even if caries there is minimal;
Lightning spread;
If you do not start treating pulpitis of baby 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 exhibit 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 has already been fully formed and until the moment when the temporary incisors begin to fall out. Sharp and acute exacerbation situation with pulp is a reaction of damaged bones to a certain irritant that has entered the oral cavity. Accordingly, treatment of pulpitis will begin with neutralizing this irritant. In most cases, such developments are observed between the ages of three and seven years. Therefore, while they are forming, you need to monitor the child’s oral cavity and no treatment for pulpitis with unformed roots not required. You need to know that single-rooted incisors are formed before the age of two, and multi-rooted canines up to three.

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

As a rule, 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 gives rise to purulent pockets due to which significantly. In this case, the pain intensifies significantly, and the child will hardly be able to accurately indicate which incisor was the first to hurt, because every bone in his mouth will hurt.

Chronic form

This type of development of pulpitis is somewhat different from acute pulpitis and can 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 immature roots in children is no different from the acute form, only it takes more time. The main sign of appearance and development is pain, which manifests itself only under the influence of a powerful irritant.

Pulpitis therapy

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

IN good clinics possible treatment of pulpitis baby tooth in one visit, but anesthesia must be given, which means the child must adequately tolerate injections into the gums. If the child allows it to be injected, the doctor will immediately cleanse the oral cavity of pathology in one procedure. 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 them from becoming infected. In this way, it is possible to localize the disease and prevent the development of complications.

Depending on how it goes postoperative period the medicine is either replaced with a new one or removed.

In some cases, due to an error, the dentist was unable to save the tooth; this happens if the unformed roots are damaged by a drill or toxins from drugs. Therefore, before starting the procedure, the doctor must warn the child’s parents about what consequences treatment of pulpitis of permanent teeth with unformed roots may have. And the parents will decide whether it is worth taking such a risk or using a conservative method of therapy. Regardless of this, we can say that rather than sit and decide to treat or remove pulpitis of a baby tooth, it is better to always monitor the condition of the child’s oral cavity, remind him of regular brushing and occasionally consult with a dentist. Examinations by a dentist will help you avoid pulpitis and a host of other dental problems.

Pulpitis, as the name suggests, is inflammation of the pulp. It can occur due to a violation of the dental treatment technique, for example, installation of low-quality fillings, grinding of teeth, surgical intervention on the periodontium. But most often this disease in a child is a consequence of advanced caries. It is carious processes that cause pulpitis in baby teeth.

Tooth pulpitis is much more common in children than in adults. This happens due to the fact that baby 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 these are not all the reasons. In primary teeth, the infection quickly progresses to the dental pulp due to the fact that the dentinal tubules are wide. Another feature of the course of pulpitis in primary teeth is that wide tubules promote 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 be completely asymptomatic. Because of this, it can be difficult to determine that the disease is developing.

Symptoms by which pulpitis can be identified are discomfort when tapping the teeth or chewing. The fact is that the pulp in baby 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 insufficiently formed the immune system. The pulp in baby 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. The acute form very quickly turns into a chronic form, and its course can be almost unnoticeable for either the child or 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. Often the pain occurs at night.

The following are noted character traits acute pulpitis:

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

Acute pulpitis in teeth with unformed roots proceeds unnoticed, in contrast to damage to permanent teeth with formed roots. In the second case, the inflammatory process is accompanied by sharp pain, and the child can pinpoint exactly which 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 tooth hurts. The danger is that general shape 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.

Fibrous pulpitis often develops in baby teeth, which later turns into gangrenous pulpitis. As a rule, they develop when the tooth cavity is closed.

With gangrenous pain there is pain from hot, putrid smell, sensation of tooth enlargement. This form may be accompanied by periodontal inflammation, swelling, and is characterized by painful probing.

Chronic fibrous pulpitis can preventive examination discovered by a dentist - a small carious cavity with softened dentin is revealed. Pain from hot or cold goes away quickly.

Treatment in children

Treatment of pulpitis is carried out with the aim of eliminating the inflammatory process, preventing periodontal diseases, creating favorable conditions for the formation of permanent teeth. In pediatric dentistry, it is important that all procedures are simple, quick and cause minimal discomfort.

Treatment can be conservative ( biological method) or surgical.

Biological method

Photo: Conservative treatment pulpitis

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

The pulp and the bottom of the cavity are covered with calmecin or a paste made from a mixture of artificial dentin powder and Shostakovsky balsam. After drying, a filling is placed from phosphate cement or silidont with a fluorine cement gasket.

Opinions regarding the use of biological methods are controversial. On the one hand, preserving the pulp will allow the tips 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 preserve the viability of the root pulp, since only its coronal part is removed.

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

Pulpotomy is performed after injection painkiller. The procedure can be performed in one or two visits.

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

To stop bleeding, use an adrenaline solution. It is important to note 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 involves 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 mature teeth.

It is important to pay Special attention for anesthesia. This method is not widely used in pediatric dentistry due to the labor-intensive and time-consuming process.

Devital methods

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

During 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 overgrown granulation tissue.

Photo: Devitalizing paste DEVIT-ARS

The procedure is carried out under topical anesthesia, for which a 3% solution of dicaine, anesthesin powder and other means 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 tampon is applied with a mixture of phenol and formalin in combination with an anesthetic drug.

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 effect of which is designed for 7-14 days.

The advantage of using this method in pediatric dentistry is that there is no need for local anesthesia.

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

During the third visit, resorcinol-formalin paste and a gasket are applied to the orifice and a filling is placed.

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

If the temporary dressing is not tightly applied, the paste can leak out and cause necrosis of the tongue, cheek, and gum mucosa. An overdose of the substance causes acute arsenic periodontitis, which requires long-term treatment.

For acute inflammatory reaction On the first visit to the periodontium after opening the cavity, exudate is drained and anti-inflammatory therapy is prescribed - acetylsalicylic acid, salphonamides, 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 their choice of clinic and dentist seriously. Violation of the treatment process of any form of pulpitis can lead to periodontitis, purulent periostitis, and acute osteomyelitis.

Video: treatment

Photo:

Photos, of course, will 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 about the fact 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 baby tooth. Pulp is a soft connective tissue that fills the internal cavity. A feature of childhood pulpitis is that inflammation of the pulp occurs without pain, which makes treatment difficult 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 disease increases.

Discomfort and unpleasant sensations 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 in baby 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 causes injury with medical devices.
Outdoor games and sports - careless movement, a blow or a fall damages the tooth and 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.
Incorrect home treatment- at the first sensation of pain, you should not apply heat (for example, a heating pad), this contributes to the development of infection.
Incorrect medical treatment- antiseptic drugs and filling materials can cause individual intolerance and make the situation worse.
Chemical irritants - alkalis, acids, drugs that destroy the surface.

Development and classification

Pulpitis in children progresses under long-term exposure to external irritants. There are 2 possible 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, causing discomfort.
Chronic (fibrous) - manifests itself when immunity decreases.
Chronic (gangrenous) - accompanied by pain and inflammation.

With acute pulpitis of primary teeth, periodic pain is observed, which intensifies when eating, drinking hot, cold and sour drinks.

Features of acute pulpitis:

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

Pain and reaction to external stimuli pass quickly (the child no longer complains of discomfort in the oral cavity), and pulpitis becomes chronic.

Chronic fibrous form often discovered during a routine dental examination. There is a small cavity with caries and softened dentin. Discomfort from food and drinks is minor.

The fibrous form can develop not only in an open carious cavity, but also under a filling. In the latter case, pulpitis manifests itself permanently aching pain. It can only be detected by radiography.

Features of the gangrenous form:

putrid odor from the oral cavity (a consequence of tissue decay);
swelling of the mucous membrane;
the child experiences a feeling of tooth enlargement and throbbing pain;
appears acute reaction when eating, eating hot and cold;
the natural whiteness of teeth is lost;
When probing during an examination at the dentist, pain is felt.

Symptoms

It is important for parents of a 3-7 year old child to periodically examine the oral cavity for yellow, brown spots and holes. The main period of pulpitis in primary teeth is asymptomatic. Diagnose the disease early stage It’s difficult, the baby is not always able to explain what’s bothering him.

General symptoms of pulpitis of primary teeth in children:

Swelling of the mucous membrane around the affected area.
Enlarged lymph nodes in the neck.
Painful sensations due to exposure to external irritants.
Deterioration in 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 you should not try to correct the situation at home using painkillers and rinses. Medicines can relieve pain, but do not cure the cause. Another wrong tactic is to wait until the tooth falls out on its own. Long-term ignoring medical care leads to intoxication and blood poisoning.

Treatment

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

There are 2 methods of treating pulpitis of primary teeth:

Conservative (biological method).
Surgical.

The main tasks of the doctor in the treatment of pulpitis of primary teeth are: relieving the inflammatory process, protecting the periodontium (connective tissue) and creating favorable conditions for the growth of permanent teeth.

When visiting a dentist, children often behave anxiously - they get nervous and cry. It is worth considering that mild sedatives are used to relieve tension. Before administering pain medications, parents should warn the doctor about allergic reactions(if any) for medicinal products or their components.

Conservative method used in the treatment of fibrous pulpitis. At the initial stage, the dentist opens the affected cavity. Next, the bottom is covered with artificial dentin and special balm. Afterwards the hole is plugged filling material. Preserving connective tissue allows the upper part of the roots to form correctly in the future.

Pediatric dentists are wary of conservative method due to 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 canals retain their viability.
Devital method - the pulp and granulation tissues (connective tissue formed during the inflammatory process) are cut off, and an arsenic-based paste is placed into the cavity.

The method has contraindications - it cannot be used with unformed roots or 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 filling material is inserted.

Side effects

Consequences of treatment of pulpitis of a baby tooth:

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

Unpleasant consequences after treatment arise due to the unprofessionalism of the dentist. For quality treatment You should contact trusted clinics and not chase 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 various kinds tricks. Despite this, examinations by a doctor twice a year are necessary, as are other preventive measures:

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

Formation the right habits and literate eating behavior for a child - a guarantee of beautiful and healthy smile adult.

Caries is a fairly common problem with children's teeth, and many parents believe that its treatment is not so important because the teeth are baby teeth and 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 for inflammation of the dental pulp, which is deep-lying tissue inside the teeth. connective tissues with nerves, blood and lymphatic vessels. Popularly, the pulp is often simply called the dental nerve. The disease mainly affects primary molars, with the lower teeth becoming inflamed more often, although pulpitis of the anterior primary 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.

Causes

Pulpitis is an inflammation of the dental nerve Most common reason The infection first affects the enamel, then spreads to the dentin and eventually enters the pulp. Much less often, the development of pulpitis is provoked by tooth trauma, including accidental exposure of a nerve caused by a dentist during treatment of caries.

Symptoms

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

Serous, during which the pulp becomes inflamed and the canals are filled with serous fluid. The child begins to complain about very severe pain in the tooth, which usually appear at night or during chewing. The 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 moves to the next stage.
Purulent, during which purulent contents begin to form in the canals. The severity of this form is influenced by various factors, for example, the child’s immunity, bacterial activity or the condition of the tooth roots. Painful sensations may not be pronounced if the child’s immune system works well, microorganisms in the tooth are weakened, and pus comes out through the carious cavity. But much more often the pain syndrome is severe. The pain is very long-lasting, sometimes radiating to other teeth, and appears both 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 enlarged lymph nodes.

Pulpitis of a baby tooth is accompanied by pain

Chronic pulpitis often occurs without symptoms, and it can develop in teeth deeply affected by caries and under fillings. The tooth may hurt due to food getting into the hole or from a cold drink, which is why the child usually does not eat on the “sick” side. In the gangrenous form of the disease, pain in the tooth appears after hot food after some time, an unpleasant odor emanates from the tooth, and the child may feel bloating 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 timely detection of pulpitis, it is important to regularly visit the dentist with your child, as well as treat all teeth affected by caries at an early stage.

Signs of serious dental damage

The following symptoms will indicate that it is important for your child to be seen by a pediatric dentist as soon as possible:

Severe pain in the tooth.
The appearance of pain when eating hot food or cold drinks.
Unpleasant smell from a darkened tooth.
Inflammation of the tissue around the tooth.
Increased body temperature.

With pulpitis, an increase in body temperature is possible

Is it worth treating baby teeth for pulpitis?

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

The consequences of untreated pulpitis can be very serious.

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

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

Stages and methods of treatment

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

Traditional

In most pediatric dentistry government institutions Pulpitis is treated in a way called “devital amputation.” It involves 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 keep the paste in the tooth for 24-48 hours. Arsenic-free paste is applied for a period of up to 7 days.
In the next two visits, a special mixture is “pumped” into the tooth canals to mummify the infected pulp. Usually this is a resorcinol-formalin mixture.
At the next visit, a permanent filling is installed.

Most often, when treating 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.

When the tooth canals are thoroughly processed, infected tissues are removed and sterile conditions are created, an anti-inflammatory paste is used to fill them, which will be absorbed along with the roots during the period of tooth change. The most commonly used is zinc eugenol paste. The method is effective, but to prevent the infection from reactivating again, cleaning the canals must be very thorough.

One more modern method called vital amputation, the essence of which is to remove the upper section of the nerve and install it on the remaining pulp medicinal product with antiseptic and anti-inflammatory effects (Pulpodent and Pulpotek materials are often used). The medicine is hermetically sealed bottom part pulp, maintaining its viability.

Specifics of treatment of teeth with immature roots

The roots of baby teeth form long time after eruption, therefore, situations are possible when a tooth becomes infected with caries, the apex of which has not yet closed at the roots. The difficulties in treating such a tooth are due to the following factors:

The roots of the teeth are short and their canals are wide.
Top part The roots represent the “growth” zone, injury to which will prevent root formation.
There is enough high risk infection of the permanent tooth germ.
It is important to perform all manipulations as carefully as possible.
The filling material and instruments must not be allowed to leave the area where the apical foramen begins to expand.
It will not be possible to completely remove the pulp and treat all the canals.
The best solution would be amputation treatment. It involves removing the infected pulp from the tooth using any method (with or without arsenic).
A biological method is often used, the essence of which is to clean the tooth of dead tissue and place it in it for several days. medicinal paste with calcium hydroxide, after which a permanent filling is installed.

Preparing for treatment

So that the child 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 instruments used. Before you go to have your teeth treated, you should:

Talk to your child about doctors who treat teeth.
Tell the baby about positive effects treatment.
Emphasize that this is a common procedure for all people to take care of their health, and not something very important and exceptional.
Play “dentistry” with toys and family members.
Do not frighten your child with scary terms.
Don't lie that there won't be any pain. It is better to say that unpleasant sensations are possible, but as a result toothache will stop.
The parents themselves should not panic or be afraid, so that the excitement is not passed on to the child.
Visit the doctor in the morning when the child is active, not hungry or sleepy.
Bring your favorite toy with you so that it remains in the child’s hands during the visit.
Give the doctor the opportunity to communicate with the child without parental participation so that the doctor finds contact.
Do not intimidate or beg the child if he does not allow himself to be examined.
If you have lost control of the situation, reschedule the appointment for another time.

Many parents have a misconception that there is no need to treat baby teeth, because after some time they will fall out and be replaced by permanent ones. This statement is fundamentally incorrect, because if the disease is neglected, “adult” teeth will form incorrectly, 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 provided for the child.

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

Pulpitis is inflammation in the neurovascular bundle, the pulp. It provokes the entry of pathogenic microorganisms into the tooth cavity. It often appears as a complication of caries.

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

The child’s immature immune system causes inflammation to quickly begin in the baby tooth. The causes of pulpitis include:

structural features of baby teeth;
caries;
infectious diseases;
mechanical, chemical, thermal damage to enamel;
improper treatment of caries.

In children 4-5 years old, pulpitis occurs very often - these are the main patients of the pediatric dentist. Less commonly, it affects 2-3 year olds and children over 7 years old.

Forms of pulpitis and characteristic symptoms

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Pulpitis can be acute or chronic. At the same time, the disease passes into a permanent form quite quickly, within a few hours. This happens unnoticed, asymptomatically, nothing bothers the baby 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 experience slight pain when chewing and at night. Acute form is rare; pediatric dentists mainly diagnose chronic pulpitis.

Acute form of the disease

Symptoms of acute pulpitis:

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

Pulpitis of baby teeth acute phase

When baby teeth are affected, the pain is not as sharp as in an adult. Often children cannot determine exactly where they appear painful sensations. They say that all their teeth hurt at once.

Attacks of pain can recur at significant intervals, so at the first symptoms of pulpitis it is important to visit a pediatric dentist. If the disease is neglected, it will develop into general acute pulpitis. It, in turn, is complicated by acute periodontitis, periostitis, and significant intoxication of the body.

Giving painkillers without consulting a specialist is not recommended. You can only alleviate the condition of a sick baby once and immediately seek help. dental care. Also, you should not make warm compresses, because with purulent pulpitis they will only worsen the situation and increase the amount of pus.

Chronic form

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

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

Infectious chronic pulpitis in a child

When you press on a damaged tooth, the pain intensifies. During the examination, the pediatric dentist will notice darkening of the enamel. Enlarged lymph nodes often occur, such as general reaction body for inflammation.

Pulpitis of permanent teeth in a child

When permanent teeth and their roots are affected, pulpitis in children occurs with all the “adult” symptoms. It is easier to diagnose because at this age children can already describe what is bothering them. Thus, the disease can be detected at an early stage.

Signs by which pulpitis in children can be identified:

mild pain without cause;
pain gradually develops that occurs when irritated by cold or hot;
pain intensity increases at night;
pain radiates to the temple, the back of the head under the eye socket.

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

Methods of therapy used and stages of treatment of pulpitis

If caries or pulpitis is suspected, the child should be shown to a pediatric dentist. The doctor will diagnose the disease and determine a treatment strategy. If necessary, they will be appointed additional research– radiography, electroodontodiagnosis (EDD).

Treatment of baby teeth with unformed roots differs from treatment of an adult, so it is better to contact a proven, competent specialist. Folk remedies and self-medication will not help in the treatment of pulpitis; 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 primary teeth. The cavity is opened, and calmecin or a paste made from a mixture of artificial dentin powder and Shostakovsky balsam is placed into it. After this, a filling made of phosphate cement or silidont with a fluorine cement gasket will be placed.

Devital treatment

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

The entire procedure takes place under anesthesia and is carried out in several stages. First, 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.

When repeated, the pulp is removed and a tampon with resorcinol-formalin liquid is left for several days. On the third visit, the dentist will apply resorcinol-formalin paste, a gasket and install a filling.

This method allows the roots of baby teeth, and then 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 place over several visits to the dentist. When the diseased pulp is removed, the tooth stops receiving nutrition. To perform this procedure, you will need to put your child under anesthesia.

Experts try not to use this method because it is painful, complex and lengthy. Still, the emphasis is on preserving and curing the diseased pulp.

Complications after treatment

Improper treatment of pulpitis in baby teeth or failure to consult a specialist leads to damage to the permanent tooth germ.

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

Only 5-7 days are given for post-filling pain after treatment of pulpitis. If your child still has a toothache, you should definitely visit the dentist, otherwise you may miss the development of complications.

TO serious complications neglected pulpitis can be attributed to:

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