Few children are able to calmly respond to a visit to the dentist. Most of all they are afraid of the drill – an unknown, very noisy and suspicious device. But the situation may become even more problematic if a sharp toothache is added to this, indicating child pulpitis. To avoid this, you need to know exactly how to prevent and determine pulpitis of the tooth in children.
Pulpitis in children is the same pulp inflammation found in adults. But, as a rule, this disease is more common in childhood. A similar pattern is associated with a rather loose connective tissue of milk teeth, as well as wider root canals and less mineralized dentine. Also, the pulpitis of the baby tooth is more common than the molars because the children still have unformed immunity. That is, the risk of having any inflammation or a common cold is much higher than that of adults. But nature has balanced this unpleasantness – there are practically no pain effects in children. However, the absence of pain is not always a sign that there are no problems.
Pulpitis baby teeth – a common disease in children
It is quite problematic to detect pulpitis in a 2-year-old child, but if you know the types of such inflammation, the chances of timely diagnosis of the disease will increase significantly.
Pulpitis hypertrophic type
This type of pulpitis in a child of 3 years or older is very unlikely and is mainly the result of prolonged chronic irritation. Signs of this inflammation are considered to be almost completely destroyed dental crown, as well as overgrown connective tissue due to long-term damage. And although the pain in children is not observed, except for a slight pain in the process of chewing, when probing the tooth begins to bleed. It is also important that during the diagnosis of pulpitis in children 4 years of age or other age, the doctor can distinguish the manifestations of its hypertrophic form from the periodontal granulation tissue, as well as the gingival papilla.
Gangrenous pulpitis: symptoms
The development of the gangrenous form of the disease of non-molars mainly is a consequence of acute diffuse inflammation, which, in turn, often begins to develop from acute focal pulpitis in children. At the same time there is a darkening of the sick tooth and the practical absence of pain. During the inspection, sometimes a putrid odor from the mouth caused by the breakdown of tissues is detected, but the carious cavity basically remains shallow. A bloated fistula can be found on the gum, in the area of the root apex. Also, there are cases of a painless increase in lymph nodes in a child.
Most often occurs with a shallow caries, without affecting the cavity of the tooth, and prevails over the acute variant of the course of inflammation. This disease is prone to exacerbation if the immunity of the child’s body is weakened. The symptoms of aggravation are complaints about the presence of constant pulling pain, increasing in the process of mechanical stress (pressure on the aching tooth, chewing). In addition, the exacerbation of the disease is accompanied by inflammation of the lymph nodes and swelling in the area of the soft tissues of the gums, sometimes there is a worsening of general well-being and an increase in temperature. In general, this form of the disease in children is similar to the same phenomenon in adults.
Chronic fibrous pulpitis
Chronic fibrous pulpitis of permanent teeth in children occurs as often as milk teeth. At the same time, in the teeth at the stage of resorption or formation, it often occurs with a closed dental cavity, and in already formed teeth, with a rather thin dentine in the region of the bottom of the carious cavity. Therefore, chronic fibrous pulp of milk teeth does not affect permanent teeth in any way.
This form of inflammation is characterized by complaints of pain when eating. Sometimes there are pains of a whining character after eating, which can keep for hours. Depending on the duration of the inflammatory process and the general condition of the tooth, the strength of the pain varies. Therefore, the shorter the history (the duration of inflammation), the more intense and stronger the pain, and the longer it is, the less painful the effect is and is manifested only when there is an external influence.
Partial pulpitis of acute type
It is rare to detect acute partial pulpitis in a 5-year-old child in the milk teeth, since due to the characteristics of the body of children, this type of inflammation in a few hours turns into an acute form. To notice a similar process at the initial stage of development is almost impossible, so parents will have to pay attention to the acute form of the disease. This is due to the fact that, due to the structure of milk teeth with their wide root canals and unformed roots, the exudate outflow occurs unhindered and therefore the pain is mild.
Features of the treatment of children’s pulpitis
Usually, the process of treatment of pulpitis in milk teeth is made after the development of inflammation, since initially it is very difficult to identify the disease in childhood. In addition, the diagnosis is also hampered by the psychological characteristics of children who do not tolerate the procedure of examination. Therefore, in order to avoid the transition of caries of milk teeth to a further form – periodontitis, parents are advised to take the child to a specialist every 4-6 months. And if the dentist detects the pulpitis of the milk tooth, the treatment of which is required immediately, it will proceed from the symptoms and grouping of the teeth, choosing the right method of therapy.
How to treat pulpitis in children
In pediatric dentistry, a variety of pulp inflammation treatments are used:
- With its preservation: the treatment of pulpitis in children with unformed roots by non-surgical method is a process in which the root and coronal parts of the pulp remain suitable for further functioning. In this case, the method of treatment of pulpitis in children with iodine can be involved, as well as treatment with forfenan (in case of poor passage of the canals). Forfenan is one of the best modern materials, which possesses a number of qualities necessary for maximum preservation of its own tooth – a long-lasting and effective antiseptic, reliable canal filling. This paste does not shrink, and is also radiopaque, which allows you to control the quality of the filling. However, even with conservative treatment, alkaline phosphatase can be inhibited, and the deposition of replacement dentin is delayed due to the use of outdated filling materials;
- With partial amputation of connective tissue: only the coronal pulp is removed to provide conditions for the vital activity of the root. This method is irrelevant for temporary teeth, but is highly recommended in the case of permanent disease, as it allows to preserve the root part of the pulp responsible for the formation of the tooth roots;
- Surgical treatment of pulpitis in children: in this case, both parts of the pulp, the root and coronal, are removed at once, and the canals are sealed;
- In some cases of neglected inflammation, a decision may be made to remove the diseased tooth.
Regardless of the method chosen, parents should remember that the treatment of pulpitis in children in one visit is not always possible, and it is worth counting on several sessions at once. At the first visit, the doctor will clean the tooth of dead tissue, put a medical paste and close all temporary fillings. It is possible that at the first visit the channels will be sealed. A permanent filling is placed only if the dentist has confidence that the recurrence of inflammation has been prevented.