Understanding the root canal treatment for your child
Created by Dr.Sonali Bassi Updated on Oct 09, 2012
Often parents come to me with a lot of anxiety because their child would have been advised a root canal treatment for his or her milk tooth. This anxiety precipitates to the question that why does the milk tooth need a RCT (root canal treatment) when it is going to fall out anyway. To answer this question we must first understand the anatomy or make up of our teeth.
Children’s teeth are also called primary or milk teeth. There are 20 in total, due to jaw size being small for young children. Primary teeth eruption begins at the age of 6-10 months and continues to about 24-39months.There are three types of teeth; incisors (cutting teeth), canines (tearing teeth), and molars (grinding or chewing teeth). Each tooth consists of two parts, a crown and a root. Crown is the portion we see in the mouth, visible to us and root, which embeds itself in the jaw. The tooth has three layers starting with enamel which is the protective layer, also considered the hardest tissue in the body then comes the dentin, which forms the main bulk of the tooth and lastly the pulp, which houses the nerve and blood supply of the tooth. The purpose of the primary teeth is to breakdown food into smaller pieces to aid in digestion and maintain space for permanent teeth to come through.
In children dental caries and traumatic injury are the most common reasons for a need to do a RCT. When the tooth starts decaying and the extent of decay spreads deep into the dentine-pulp border, patient may have the following symptoms,
a) Pain at night
b) Pain on biting, exposure to hot and cold
c) Intra oral or extra oral swelling
A cavity involving nerve of the tooth may cause child to experience intense pain. In such a case the dentist would decide what treatment to give to the pulp, which is called pulp therapy. This may be in the form of a root canal, Pulpotomy or pulp capping for the affected tooth depending on patient s symptoms and radiographs. The purpose of pulp therapy is to maintain the vitality of the affected tooth so that the tooth will not be lost early. Early loss of back or posterior primary teeth may cause future problems with eruption of the permanent teeth.
There are four forms of pulp therapy:
1) Indirect pulp capping: involves, where deep decay is approaching or barely exposing the pulp where removing all the decayed parts of the tooth would expose the pulp. Instead as much soft decay is removed as possible leaving only harder remnants without penetrating into pulp. We then apply an anti bacterial agent and sealing it further with a filling to prevent infection. These materials reduce acidity caused by decay and sterilize surrounding infected dentin. By allowing inflammation to subside, reparative dentin is deposited by pulp to further protect itself.
2) Direct pulp capping: involves covering the exposed area of the pulp with calcium hydroxide in cases where there is mechanical or traumatic exposure not because of carious exposure.
3) Pulpotomy: involves removing the coronal (crown) portion of the pulp leaving the root portion of the pulp behind. The main purpose behind this is to preserve the healthy part of the pulp by removing the diseased tissue. Next a biocompatible medication is placed to prevent bacterial growth and to sooth the remaining nerve tissue. A final filling and mounting a stainless steel crown follow this.
4) Pulpectomy: involves complete extirpation or complete removal of the pulp oath from the crown and root portion of the tooth. The canals are cleaned, disinfected and filled with a resorbable material. The final filling and crown is then given.
After endodontic (RCT) treatment there might be a mild soreness, this can be treated with appropriate painkillers. Keep in mind; all these procedures are best performed under local anesthesia. Sometimes if patient is not co-operative then mild sedation or nitrous oxide can also be used under appropriate conditions. In nutshell, my friends, please have a regular family check up with your dentist, and keep smiling!!
| Sep 17, 2013
Thank you Doctor, My daugther is 3 years and we need to get a root canal done for a tooth that has gone non-vital. She has a massive swelling and is been put on antibiotics. Now I have a question, she is asthmatic. What precautions should I make sure that the doctor takes. FYI - she had a very bad asthma attack 20 days back and was in the PICU for two days. Can you please guide me.
| Jan 02, 2013
thank you for the information. I have had a few root canals myself and always wishing that my child would not have to go through agony. Although in own experience, the expertise of the doctor really makes a difference in the whole experience. Its good to know what really goes on in an RCT.