If you have kids, or work with them, you are aware of how silly they can get when they are playing. Enter dental trauma and injury.
Tooth injuries are such a frequent occurrence with children, it is no surprise that our office is often full of children with tooth injuries, ranging from mild to severe. Some require the least amount of treatment. Some others often require root canals. Fortunately, pediatric dentistry is far less formidable because of one simple fact: most children do not yet have adult teeth. Either they will lose their damaged teeth in a few years anyway, or the stem cells in their dental pulp will lead to complete regeneration. Because of this, several other treatment options become possible.
Researchers now believe that two regenerative genes – IMP1 and Lin28a – are very active in fetuses and gradually weaken as the person gets older. This explains why children heal much faster than adults, especially when it comes to bone tissue. Some doctors believe that this “genetic fountain of youth” may one day have amazing applications, but when it comes to endodontics, this difference has amazing applications today.
Because children heal more quickly from bone trauma injuries, they can also heal much more quickly, and much more effectively, from traumatic tooth injuries. Moreover, some of the traditional therapies used in adults, like crowns and bridges, may not be best for children, because replacing some teeth may inhibit future growth. Also, since a child’s jaw is still developing, young children are generally not candidates for implants and related procedures.
In the following sections, you will learn about the different kinds of endodontic treatments our office offers that are specifically tailored for children.
Pulpotomies And Pulpectomies For Children
Adolescents between the ages of 7 and 12 may not require root canal treatment, as their teeth are still in the development phase. A child’s kiddy root canal or baby root canal is also known as a pulpotomy or pulpectomy. This procedure removes most of the pulp – the blood and nerve supply – from the tooth. Recent studies suggest that stem cells residing in the pulps of adolescents can spur full root growth, and heal the pulp after infection or injury.
A pulpotomy is a treatment where a portion of the pulp is removed. The portion of pulp that is removed is typically diseased. The purpose of a partial removal of the affected pulp tissues is to maintain the vitality of the affected tooth. The baby tooth thus remains intact till such time that they fall out to make way for the adult teeth to come in.
A pulpectomy is a dental procedure in which all of the pulp is removed from the affected tooth. In such a dental procedure, the pulp tissue is removed from both the crown as well as the root. Your endodontist will then clean and medicate the affected area. The final step in a pulpectomy is a restoration, typically in the form of a stainless steel crown.
Apexification And Apexogenesis
Apexification and apexogenesis are the best means of preserving your child’s teeth in emergency situations. When teeth in older children or adults are damaged, a root canal is often the best option. However, when younger children sustain similar injuries, these methods may not be the best possible approaches.
Fortunately, young children usually heal rather quickly. An experienced endodontist can use advanced pulp therapy techniques to restore the damage and promote healthy long-term tooth development.
Two essential components to saving a child’s teeth after a traumatic injury are keeping the pulp alive and restoring the root. After an avulsion or extrusion (partial dislodging), the pulp can usually be kept alive without medication for between thirty minutes and two hours. Then, an endodontist can use one of several medicines to sustain tooth pulp, including:
- CaOH: Tried and true Calcium Hydroxide has yielded effective results in many patients since it was first used in 1936.
- MTA: The Food and Drug Administration approved Mineral Trioxide Aggregate in 1998, and it is fast becoming the medication of choice, because it has fewer side effects and forms a better seal than CaOH.
CaOH and MTA are both powders that become gel-like pastes when added to water.
If the pulp can be salvaged, which is possible in most cases, an experienced endodontist can salvage your child’s teeth through one of two procedures on the roots:
- Apexogenesis: As either CaOH or MTA restores the pulp, the roots continue to develop and may only need monitoring and occasional minor intervention to reach maturity.
- Apexification: In some cases, diseased or damaged pulp must be gently extracted to make room for healthy cells. Endodontists then strengthen the root apex (tip) and closely monitor the patients to watch for hairline tooth cracks and other fractures.
Apexogenesis and apexification therapy usually takes between six weeks and eighteen months, depending on the patient’s general health, age, and extent of tooth damage.
Tooth trauma in kids can be a very serious, and common occurrence for parents. Let Dr. Aaron McCann and his staff of Buffalo Endodontists help your child when they experience tooth trauma.