Pulpitis among children deciduous teeth treatment methods

Pulpitis baby tooth is a common disease in the practice of pediatric the dentist. This is a very unpleasant and painful condition in which the baby is not able to eat ice cream or drink a Cup of hot chocolate, not to mention their favorite dishes. If the first hours to pay attention to the concerns and complaints of the child that arise during a meal, the treatment of pulpitis will take place without unpleasant consequences. The main thing is to approach it seriously and responsibly. Do not wait until the pass itself. Because, contrary to popular belief, baby teeth can and should be treated. If this process is run, the consequences can be very severe. Than to treat? Is it possible to cure at home folk remedies?

What is the pulpitis of primary teeth and how it happens

Pulpitis – is an infectious inflammation of blood vessels and nerves inside the tooth. In children it occurs faster due to the characteristics of the flow of carious process in milk teeth. This is because of the structure of hard tissues in children are much more porous and this allows the bacteria to quickly penetrate polyarnoy the camera, hitting the hard tissue in a matter of months. Also pulpitis in children can be caused by a «carob caries». This disease develops in babies in the first two years in the use of mixtures rich in carbohydrates or frequent night of breastfeeding after eruption of teeth in children, breastfeeding. This process proceeds typically on the background of General weakening of the immunity and lack of vitamins in the diet and calcium.

Chronic forms of pulpitis of primary teeth are asymptomatic, because of wide dentinal tubules contribute to the outflow of the inflammatory exudate from the cavity of the tooth. It also contributes to a smaller (in comparison with permanent teeth) sensitivity of the tissues of the pulp. The process evolves in closed cavities, which also hampers early diagnosis.

This disease can manifest itself in different ways. But the basic symptoms are similar in children and adults. It starts with pain from the hot having a continuous nature. Painful sensation occurs when eating or when shaking their head. In reversible forms of pulpitis it extends from the rinsing with cold water or by eating ice cream. A characteristic feature of pulpitis are pain night. In severe forms, the entire process may be accompanied by General malaise and fever. The child becomes irritable and capricious. But some children fear the visit to the dental office, not telling his parents about his pain. You need not to put pressure on the child and gently explain that trip to the doctor is necessary. There are several forms of pulpitis:


  • Stage:
  1. serous
  2. purulent
  3. with the involvement of regional lymph nodes

Chronic (often the result of acute);

  • Stage:
  1. fibrous
  2. gangrenous
  3. hypertrophic

Acute pulpitis

Is very rare and occurs in healthy children are not susceptible to tooth decay. Characterized by the presence of spontaneous toothache. May be partial or total. As a result of inflammation produce large quantities of exudate (fluid)in the cavity of the tooth, filling the dentinal tubules. In this connection there is a swelling surrounding the tooth tissues, regional lymph nodes and cheeks. The pulp is always closed, and the cavity filled with a bright the infected dentin. Very often it is accompanied by General malaise. A few hours serous stage passes into the purulent and there is a destruction (necrosis) of the pulp. Often, when the doctor opens the tooth cavity, there is a drop of pus.

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Chronic pulpitis

Usually develop without special symptoms and complaints and is detected at the next visit to the dentist. A cavity visible to the naked eye and filled with dark infected dentin. The hypertrophic form seems like expansion of the mucosa of the cavity, is often painful when chewing and bleeding. If a cavity becomes clogged with food residues, chronic pulpitis may become overwhelming and be the reason for timely treatment to the doctor.

To diagnose pulpitis the child is not an easy task, as his complaints and words of parents do not always coincide. In addition, children are often unable to describe the nature of pain, to determine the patient’s tooth or just not telling parents the truth in order to avoid a visit to the dentist. In addition, the main diagnostic methods used in the adult technique, such as sensing, Electrometry or even cold test it is often impossible to conduct because of the risk of inadequate response. Any actions of the physician in the pain center, can strongly frighten the small patient and to do further work of a doctor is impossible. So basically the diagnosis is made on the basis of information received from parents. Children pulpitis is diagnosed by means of percussion, palpation, determination of motility and conducting x-ray examination.

Contraindications for conservative treatment of pulpitis

  • The complete destruction of the crown, the tooth can not be restored;
  • physiological resorption of the roots;
  • physiological change;
  • expressed periapical changes (on the radiograph);
  • serious somatic diseases.

Treatment of pulpitis of deciduous teeth in children

How to cure this pathology of the baby? Severe forms are very rare mainly due to the overall inadequate cariogenic situation or the weakening of the immune system. So as soon as possible to schedule a visit to the dentist, and in any case not to self-medicate. Depending on the severity and form of pulpitis, the doctor may recommend the following methods of treatment of pulpitis in children:

Treatment of acute forms

Is performed under local or General anesthesia. First, on the gums cause the application of anesthetic gel, and then after some time gently inject a small amount (no more than 1 ml) of anesthetic. No need to be afraid of General anesthesia is better than to inflict psychological trauma of injections and dental treatments to weary pain to the child. The only thing it is advisable to treat and rest the affected teeth so as not to go to the dentist in the next six months.

Since the process may be reversible, in some cases, when the serous pulpitis develops at the closed cavity, its attempt to treat by biological methods. The infected dentin at the same time as removed, and on the bottom or the exposed nerve put the toothpaste containing calcium hydroxide. The tooth is closed a hermetic seal and, if within days he doesn’t, then we can talk about a cure. Feature of acute serous pulpitis of the child is what he is for a few hours goes into the septic and the process is pretty quick and covers all pulp tissue. In case of purulent forms is partial or complete amputation (removal) of the pulp.

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Complete removal of the pulp

The purpose of the procedure-complete removal of vessels and nerves from the tooth cavity. It is carried out only on teeth with formed roots. It is preferably carried out in one visit, but it depends only on the emotional state of the child. If you can’t make this operation in one visit opened demetalizarea superimposed nerve (kill the nerve) pasta. If the paste contains arsenic, then it is applied for 2-3 days. Bezmasljanye paste may remain in the cavity of the tooth for up to 14 days. Today, few of the physicians use a paste containing arsenic, especially in pediatric practice. Prolonged exposure to the tooth, they cause irreversible changes in the surrounding tissues.

The next visit is made removal of the neurovascular bundle of the special tools-pulpectomy and produced mechanically (using special files of different diameter) and medical (solutions of hydrogen peroxide and chlorhexidine) treatment of root canals. Their subsequent filling in deciduous teeth by a special Menominee pastes. They are able to dissolve, which is important for the roots of deciduous teeth. Materials for sealing root canals (gutta-percha) used in adults, in pediatric dentistry are applied. Then put a constant seal.

Using this method there is a risk of the following complications:

  1. failure of endodontic instrument in the canal;
  2. incomplete removal of infected pulp;
  3. the removal of the filling material beyond the root apex.

Partial removal of pulp


Partial removal of the coronal pulp but retain it in the root channels is of vital amputation. Conducted in acute reversible pulpitis, accidental opening of horn of pulp or partial destruction of the pulp in sorokovoy part of the tooth. The essence of this method-preservation of viable pulp in root canals. At the mouth of the channels when it is applied:

  • calcium hydroxide;
  • the resorcinol-formalin mixture;
  • trisulfate iron;
  • MTA (Mineral trioxide unit).

When applying calcium hydroxide treatment success is 50-60%. When using the resorcinol-formalin mixture, the remaining nerve turns into a glassy mass, tightly filling the root canal. Usually the treatment takes place in several stages, and blend demetalizarea paste until the seal takes a few visits to the doctor. Tooth after some time painted in a pink color. The effect of the application of MTA is the formation of the dentinal bridge, preserving the vitality of the residual pulp. The process of physiological resorption of roots of deciduous teeth prior to their precipitation, thus is not broken and prevents damage to the embryo following permanent tooth.
As in the first and in the second case, the tooth cavity is treated with a weak antiseptic solution, to reduce the risk of further spread of infection.

At all stages of treatment of pulpitis of a deciduous tooth, as well as permanent, complications can occur. Often in medical practice are:

  • An allergic reaction to the anesthetic;
  • The inability to properly handle the tooth cavity and, therefore, exactly in the projection of the nerve to impose a remedy;
  • Installation demetalizarea paste on the gums, usually occurs when the expansion of the pulp tissues and the inability to distinguish it from the gum tissue. Also possible leakage of drugs under the leaking temporary filling;
  • Bleeding from polyarnoe camera. Manifested pain symptom after you apply the medication;
  • In the treatment of biological method — setting calcium strip on an already dead pulp;
  • bleeding from the root canal;
  • constant leaking seal.
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The risk of complications often associated with behavioural reactions of the child when the doctor can’t work because of the whims of the child, the constant questions and restless behavior in the chair. Therefore, in some cases, you can resort to sedation. The appointment of sedatives, such as TenTen child or a decoction of Valerian will help the little patient to cope with anxiety. But despite that treat the pulpitis of primary teeth is important and it should be done in a timely manner, as the inflammatory process may go on in the bone tissue. This may damage the permanent tooth germ, and also go inflammatory changes in the adjacent anatomical areas, e.g. in the maxillary sinus.

Tips and advice

In no case do not self-medicate! To cure the pulpitis of temporary teeth in children at home is impossible, time will be lost, and the infection can spiral out of control, spreading throughout the body.
Talk at home with your child and explain the need for treatment. If necessary, brush with him, as many children’s fears removed with the help of pencil and paper. Draw the child’s house, which was built by the germs in his teeth and tell us how it is important to rid your tooth of unwanted guests.

What is usually prescribed for pain symptom

To relieve pain at the onset of pulpitis or after a visit to the dentist usually prescribe Paracetamol or children’s Nurofen. In their composition the active anti-inflammatory substance, with an impact mainly on the bone tissue, including teeth. You can give homeopathic remedies, which include nightshade, but the purpose and dosage is better to coordinate with your child’s doctor is a homeopath. However, to get addicted to painkillers is not, and, if the pain and fever of the baby was delayed for more than a day, we recommend you to go back to the doctor.

In addition to the above, you must contact a clinic specializing in the treatment of children. Most likely, there will be a possibility of General anesthesia, and allergological tests to determine the sensitivity of the baby to the different drugs. Well, if this is not possible, it is necessary to go to a doctor with experience and desire to work with children.