Pediatric Dentistry( Child Dentistry)

Pediatric dentistry is the branch of dentistry dealing with children from birth through adolescence. It is advised that a dental visit should occur within six months after the presence of the first tooth or by a child’s first birthday. An early oral examination aids in the detection of the early stages of tooth decay. Early detection is essential to maintain oral health, modify aberrant habits, and treat as needed and as simply as possible. A Pediatric dentist provides information on the finger, thumb, and pacifier habits, advice on preventing injuries to the mouth and teeth of children, diet counselling, and information on growth and development.

Fillings

Fillings help restore teeth damaged by decay back to their normal function and can prevent further decay. Your dentist will consider a number of factors when choosing which type of filling material is best for you. These factors include the extent of the repair, where in your mouth the filling is needed and the cost.

Several factors influence the performance, durability, longevity, and expense of dental restorations, including:

  • The components used in the filling material
  • The amount of tooth structure remaining
  • Where and how the filling is placed
  • The chewing load that the tooth will have to bear

Pulpectomy (Root Canal Treatment in Child Dentistry)

The pulp of a tooth is the inside soft tissue or “nerve” of the tooth. The pulp contains nerves, blood vessels, connective tissue and reparative cells. The purpose of pulp therapy in pediatric dentistry is to maintain the vitality of the affected tooth so the tooth can be maintained until the correct time for normal tooth loss (exfoliation).

Cavities (caries) and traumatic injury are the main reasons for a tooth to require pulp therapy.

Pulp therapy is often referred to as a “baby root canal”, pulpotomy or pulpectomy.

A pulpotomy removes the diseased pulp tissue within the crown portion of the tooth. A disinfecting agent which also calms the remaining nerve tissue is then placed in the tooth. This is followed by a final restoration (usually a stainless steel crown).

A pulpectomy is required when the entire pulp is involved (into the root canal(s) of the tooth). During this treatment, the diseased pulp tissue is completely removed from both the crown and root. The canals are cleaned, medicated and in the case of primary teeth, filled with a resorbable material. Then a final restoration is placed (usually a stainless steel crown).

Space Maintainers

Baby teeth aren’t just for chewing. Each one also acts as a guide for the eruption of the permanent tooth that replaces it. If a baby tooth is lost too early, the permanent tooth loses its guide. It can drift or erupt into the wrong position in the mouth. Neighbouring teeth also can move or tilt into space. This means that there may not be enough space for the permanent tooth to come in.

Dentists call baby teeth primary or deciduous teeth. Primary teeth can be lost too early for several reasons:

  • They can be knocked out in a fall or other accident.
  • They may need to be extracted because of severe decay that causes infection.
  • They may be missing at birth.
  • Some diseases or conditions can lead to early tooth loss.

Space maintainers may be used:

  • If a primary tooth is lost before the permanent tooth is ready to come in
  • If a permanent tooth is missing

The maintainer keeps the space open until the permanent tooth comes in.

Types of Space Maintainers

A space maintainer is made of stainless steel and/or plastic. It can be removable. Some space maintainers are cemented onto the teeth on either side of the space in the child’s mouth. This is called a fixed space maintainer.

A removable space maintainer looks like a retainer. It uses artificial teeth or plastic blocks to fill in space or spaces that need to stay open. This type of space maintainer often is used when space is obvious to other people. Removable space maintainers work well in older children who can reliably follow directions about caring for this appliance.

Most commonly used fixed space maintainer is a  band-and-loop maintainer is made of stainless steel wire. It is held in place by a crown on the tooth next to the space or an orthodontic-type band around one of the teeth next to the open space. A wire loop is attached to the band or crown. It sticks out across space where the tooth is missing and just touches the tooth on the other side of the open space. The wire loop holds the space open. This allows the permanent tooth enough space to come into the mouth without crowding.

Evaluating Your Child

A thorough dental evaluation of your child’s new permanent teeth will determine whether or not they have pits and fissures and an increased risk exists for developing dental caries. Not all teeth that carry this condition require sealing, which is why a pediatric dentist can perform an analysis of these new teeth to see if it is necessary. Having identified if the pits and fissures are deep enough to warrant the application of a sealant, the dentist will give you this recommendation. Ultimately, however, it is up to the parent. You’ll know it’s urgent if you can see grooves and hollows on the surface of the back teeth.

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