What is endodontic treatment for children?

Endodontic treatment deals with the pulp of your tooth. The pulp of your tooth has nerves and blood vessels that give the tooth its oxygen and nutrients. When the pulp of your tooth is injured or if it becomes infected, endodontic treatment is needed to save the tooth. Your child may need endodontic treatment in the following cases

• there is pain in a tooth for no apparent reason
• the tooth has become sensitive to changes in temperature
• there is a broken tooth with an exposed pulp

Endodontic treatment can be performed on permanent and primary teeth. Even if your baby teeth will fall out, your dentist may suggest having it fixed unless it would be falling out soon. Your baby teeth are important for chewing, proper speech, and they will also guide your permanent teeth into their proper places. If your child loses a baby tooth too early then the neighbouring teeth may move into the empty space. It can block the permanent tooth from coming in or it may end up tilted.

There are two kinds of endodontic treatment for your baby teeth and they are vital pulp therapy and non-vital pulp therapy. In vital pulp therapy, the tooth’s pulp is removed from the crown of the tooth and not from its roots. In non-vital pulp therapy, the pulp is removed from the crown and from the root. This is also known as root canal treatment. If none of these methods work then the tooth will be extracted.

Vital pulp therapy for primary teeth

There should be no swelling or abscesses for vital pulp therapy to work. The tooth must not be loose as well. Four types of vital pulp therapy can be performed on your primary teeth and they are

• protective base is used when there is decay in the tooth and no affected pulp. In this type of therapy, the decay is simply removed and protective material is placed on the tooth. Afterwards, the filling is placed
• indirect pulp cap is performed if the decay is really close to the pulp but has not yet affected it. Most of the decay is removed and a protective dressing is placed over it. This will prevent from exposing the pulp and it will also hasten the healing process. A filling is placed afterwards
• direct pulp cap is performed when a small amount of pulp is exposed. This can happen because of decay or because of an injury. The exposed pulp will be treated with medication in order to protect it. Direct pulp caps for primary teeth don’t work as well as they do in permanent teeth
• vital pulpotomy is performed when the top part of the pulp has been affected by decay or if the top part has been injured from an accident. The dentist removes this decay and any injured for The root part of the tooth is still healthy so it is left alone. The inside of the tooth is packed with a protective material and then the tooth is enclosed with a stainless steel crown. Vital pulpotomy can be done on baby teeth and on adult teeth that have not finished growing a full length root. For adult teeth, this is only a temporary solution until the tooth finished growing its root. Vital pulpotomy can also be done as a first step in root canal treatment

How is non-vital pulp therapy done for primary teeth?

Non-vital pulp therapy is another name for the famous root canal treatment. This has to be done when the pulp is too damaged and it can not be saved anymore. The dentist will remove all the pulp inside your tooth and then it will be cleaned. The tooth will then be filled with a special material. This material will be absorbed by the body until the tooth falls out. The stainless steel crown is placed on the tooth so that it is protected. If the tooth is in the front of the mouth then the stainless steel look can be covered with a material that matches the colour of your teeth. This whole process is usually done in multiple visits.

Should you have a root canal treatment or a tooth extraction for your primary teeth?

Your dentist will provide you with the information that will help your decide whether to have your primary tooth extracted or have a root canal treatment. This will depend on

• the tooth that is affected
• when the tooth will fall out
• the amount of damage done on the tooth
• whether the problem has affected your gum tissue or your bone

If your child has serious medical problems then they should not risk getting an infection because it can be very serious. If the tooth was damaged by an infection then it is possible that the tooth can get infected again, even after a root canal treatment. In cases like this, tooth extraction may be the best option. If the tooth is still healthy and removing it may hamper the child’s speech, affect their eating, or affect the way the permanent tooth will come out then root canal treatment may be the better option. After endodontic treatment, your child may experience soreness but this should not worry you because there are over the counter pain relievers for children.