Caries of milk teeth in children and their treatment: what parents need to know
Baby teeth with caries in children need to be healed. Some parents’ approach "You will fall out anyway, there is nothing to torture a child and spend money" is a crime against baby’s health.
Timely treatment of tooth decay of deciduous teeth is even more important than treatment of permanent teeth. And here’s why:
- The normal teething of permanent teeth and the bite formation largely depends on the health and the timely change of milk teeth. A full set of baby teeth makes the right jaw size. If they are destroyed by caries and fall out or are removed prematurely, the jaw cannot be shaped properly. It is very likely that in the future there will be a wrong bite or a curvature of the teeth, their unsightly place. As a result, a child who has not been cured in a tooth is paid for with braces at the most when it is mature, and at worst with staggered teeth with psychological complexes.
- Caries on milk teeth can be complicated by pulpitis and periodontitis, which can cause cysts in the root zone, and by the germ of a permanent tooth.
- Running tooth decay is often a reason for ridicule in the children’s team.
- Also, do not forget that the appearance of tooth decay is a sign of violation of the rules of oral hygiene, improper nutrition or lack of minerals in the diet and sometimes – a symptom of problems with the immune system. If you ignore these problems at the beginning of your life, you can get through to the middle of your child without healthy teeth and with a number of related diseases.
- With the premature removal of chewing gum teeth, the child is unable to chew normally. As a result, an insufficiently processed lump of food will enter the gastrointestinal tract, which can lead to indigestion.
From the practice of the dentist
Often parents don’t even treat severe forms of caries complications, and a child’s periodontitis can turn into periostitis, osteomyelitis, an abscess, or a phlegmon. In addition, the death rate in children from caries complications is higher, since certain factors weaken the immune system, the process from pulpitis to abscess and phlegmon in a child can take a few days and even occur within a day.
Therefore, the first thing when caries of milk teeth can be seen in a child is to contact a pediatric dentist. After the examination, the doctor will tell you how and which teeth need to be treated, which methods and means to use them and how the treatment should be as comfortable as possible for the child.
Caries can only be treated in very rare cases. The doctor usually makes such a decision if a child’s tooth change has already begun, tooth decay is found that can fall out within six months, and the disease itself is sluggish, chronic. In this case, tooth decay will simply not have time to have serious consequences. However, we repeat: This decision can only be made by a professional dentist based on an examination of the child.
The peculiarities of the treatment of milk teeth
Treatment caries of milk teeth in children taking into account the peculiarities of the structure and life cycle of the teeth themselves.
For example, milk teeth are quickly erased. This is a normal process that needs to be considered when choosing the sealing material. If the material is harder than the tooth itself, the filling begins to protrude beyond the surrounding tissue after a certain time, preventing the child from chewing.
Glass ionomer cements are typically used in the treatment of caries on milk teeth. In this case, in addition to the abrasion of the filling, which naturally occurs simultaneously with the adjacent walls of the tooth, fluorides are infiltrated into the surrounding tissue, which in turn contributes to their additional mineralization and strengthening.
In addition, children often have a bottle and blooming caries that develops very quickly. While the parents have time to notice the disease and take the child to the doctor, the pathological process can spread to most teeth and cause severe damage to some of them. As a result, almost all teeth have to be treated, and this has to be done in several sessions, and the therapy itself will be very tiring for the child.
Methods of treating tooth decay at various stages of the disease
In the early stages of caries development, when only tooth enamel is damaged, it is usually possible to get by with conservative remineralization therapy. No drill is used: the demineralized areas of the teeth are first cleaned and then treated with special preparations that allow the damaged tooth enamel to be restored.
Today, the ICON (Aikon) technology is also used for the treatment of initial caries: A special composite material is applied to the damaged part of the tooth, which fills all pores that result from a carious lesion. This material hardens and protects the treated area reliably and in the long term against further destruction.
Thanks to ICON caries treatment technology, regular examinations of a child at the dentist are becoming increasingly relevant. It is much more efficient and easier to treat tooth decay at an early stage without drills and fillings than to torture a baby later in the event of tooth enamel and dentin destruction.
However, it should be noted that for cervical defects that are close to the edge of the gums, the ICON technique is limited due to too thin and poorly mineralized enamel (dentin cannot be infiltrated with the medication used). Children under the age of 3 using this technique are not welcome.
Regular examinations of the teeth in a child can not only uncover hidden caries processes and determine the cariogenic situation in the oral cavity, but also lay down a series of necessary rules for the parents to maintain the surfaces of the teeth that are not affected by caries. It is important to start cleaning as soon as the first milk tooth appears. It is sufficient to wipe the tooth with a special napkin or to use a toothbrush napaletnik for this purpose.
The first real toothbrush for a child should be:
- With very soft bristles;
- With a small and non-traumatic round head;
- With a comfortable handle.
Class cleaning should take the form of a game. It should start from 1-1.5 years. The cleaning of all surfaces accessible to the brush and the support of the child is monitored by adults. The combination of brushes with children’s toothpastes is recommended no earlier than 2 years if the child learns to spit.
Today, another method of conservative treatment of caries on milk teeth without a drill, silvering, is increasingly recognized as obsolete. If it is silver salts that are applied to carious areas, this leads to the death of bacteria (silver has bactericidal properties) and in the future – to protect these areas from repeated caries lesions.
The silver salts on the surface of the treated area are used to restore fine metallic silver that has a dark gray color. It spoils the appearance of the teeth very much, and with them the baby’s mouth looks no better than with caries. In addition, the silver plating needs to be repeated once a month, which can be quite problematic.
In general, the effectiveness of silvering the teeth to prevent the development of tooth decay is rather poor.
When caries penetrate under the enamel and remove dentin, the infected cavity is cut out, disinfected and filled with a filling material. In some clinics, carious lesions are cleaned without a drill using a jet of abrasive material or special substances that dissolve the affected tissue, and in some clinics a laser is used to remove the affected tissue, but is assigned to a doctor the child’s age and the specific clinical situation must be taken into account.
In rare cases, for example in the case of heavy forms of bottle caries, long before a tooth change, crowns for children are installed with a special technology (no tooth rotation is carried out). Such crowns are usually made of metal for the chewing teeth and composite materials for the incisors. In this case, the crown is installed in a visit to the dentist, and the crowns on the front teeth are installed in just 20-25 minutes.
Anesthesia, local anesthesia and painless treatment: psychological aspects of therapy in children
Controlling the patient during treatment is no less difficult than the actual caries therapy itself. The children themselves are restless and it is incredibly difficult to keep them in a chair for at least half an hour.
The problem is made worse if the child is afraid of the dentist or the drill and is waiting to be painful. He just can’t open his mouth. And the younger the child, the more acute the problem, which is solved in several ways:
- Many children aged 6-7 are obedient enough and the presence of a parent in the office allows them to sit still.
- The presence of distracting design elements in the office (for example drawings on the walls, toys on the ceiling), a television near the chair, a bright robe at the dentist – all this distracts and keeps the child’s attention on themselves Can look at objects or watch the cartoon .
- The use of colored fillings. If the child knows what it is, he willingly endures it all the time just to get such a seal and then brag to his friends.
- Local anesthesia for children who are afraid of pain during dental treatment. Before the injection, the child is treated with an anesthetic seal and the baby does not experience an injection or pain during the further work.
- Nitrous oxide sedation, in which the child relaxes, his anxiety is dampened, a short sleep can occur.
It is the anesthesia that parents fear most. This is wrong: most of the drugs used today for general anesthesia are safe, especially before the actual treatment, the child carries out the tests and carries out the necessary tests to ensure that there are no individual contraindications to the use of the anesthesia. And the doctor himself only uses anesthesia when other means and methods do not allow manipulation.
Many parents are afraid that anesthesia can affect the child’s intellectual development, affect his memory, and lead to a delay in language development. Such situations are theoretically possible, but they are extremely rare. Statistics show that such complications of anesthesia are extremely rare in children, and in many cases the cause of a developmental disorder is not anesthesia itself, but severe hospital anxiety or the effects of the disease treated with anesthesia.
"In Sweden there are no options besides anesthesia. She is three years old, trusts the doctor, sits in a chair, does not cry, but simply says no. She said – the doctor didn’t. It is impossible to force her because it is child abuse and she refuses. I had to do anesthesia. She left it for a very long time, but there were no consequences. "
In cases of neglected bottle caries in children under 3 years of age, anesthesia is the only way to manipulate. Treatment can take at least 2-3 hours and it is impossible to leave the baby motionless in an unfamiliar environment all the time.
In any case, the final decision is always made by the parents. The doctor himself will not perform anesthesia and will perform the surgery if he has concerns about the consequences of the anesthesia for the child.
Practice shows that overwhelming common sense wins and parents consent to anesthesia instead of endangering the health and beauty of the child in the future.
"I have a son of 4.5, a daughter of 2 years. We went for the examination, the son found two small holes, and the daughter had caries on 5 teeth, there is a plaque and one tooth is already without a tip. The doctor immediately offered us anesthesia. Although the clinic is good, I was kind of scared. I read about Sevoran at home, there doesn’t seem to be anything terrible in it, but the anesthesia is still 2.5 hours away – that’s more than appendicitis! They decided to refuse, they coped with their son. And cartoons showed him everything, promised everything in the world and read fairy tales, but healed his teeth, one for each visit. And Sasha didn’t even open her mouth. She said no, that’s all, what is there to do? I had to do anesthesia, but everything was fine, it cost. "
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