Paediatric Dentistry

Paediatric dentistry is a branch of dentistry that deals with the management of dental problems of children right from infancy to adolescence. Primary teeth are the first set of teeth that erupt in the oral cavity.

The first tooth erupts somewhere around 6 months and the rest of the eruption continues till 2-2.5 years of age. Primary teeth are highly susceptible to caries due to frequent snacking by children and lack of adequate care as well.

If a primary tooth gets carious and is left untreated, then the infection can spread to pulp and periodontal spaces and it can cause severe pain to the child. You would be surprised to know that dental caries is the second most common chronic disease affecting children after asthma.

How would I know if my child has an infected primary tooth?

1. Hollow tooth structure
2. Food lodgement
3. Pain during biting
4. Pain during night
5. Pus drainage around the tooth
6. Swelling
7. Pain on touching

When a child complains of any of the above-mentioned symptoms then the tooth has been infected and we have to carry out either pulpotomy or pulpectomy to save the tooth.

What is Pulpotomy?

This is a procedure done mostly done in primary teeth. The coronal portion of the pulp is removed and the radicular portion is left like that. This is less invasive than pulpectomy.

Since the nerve tissues of the primary teeth have to capacity to repair and regenerate, this procedure can be carried out with success.

After cleaning the coronal portion of the tooth, it is filled with medicament and then left to heal.

However, this procedure can be done when the:

1. Caries have not damaged the pulp significantly
2. The pulp has not been exposed to the outside environment.
3. When there is no excessive bleeding or necrosis of the remaining pulp tissue it shows signs of healing.

The tooth can be secured with a stainless steel crown after the procedure.

What is Pulpectomy? What are the steps involved?

When the pulp has a high incidence of infection and profound symptoms are seen as well, then the procedure of pulpectomy is carried out.

This is the procedure of complete removal of the infected pulp from the tooth. The procedure involves the following steps:

1. Cleaning of the tooth: After a thorough examination, the tooth is cleaned well and the infection is drained from the tooth. The whole infected pulp tissue is removed from the coronal and the radicular portion.
2. Filling the canals: Once the tooth is cleaned, the canals are filled well with biocompatible materials like Calcium Hydroxide, Zinc Oxide Eugenol, or MTA. The filling material used for a child is different from that of the adults because the primary tooth undergoes resorption and the material should resorb along with the tooth.
3. Delivery of the crown: To ensure that the functionality of the tooth is maintained, the tooth is fitted with a stainless steel crown. We provide zirconia crown also in a few cases.

Besides this, the various procedures that are carried out at our clinic are:

1. Dental restorations
2. Treatment of nursing bottle caries: Many children who are fed with milk during the nighttime suffer from nursing bottle caries. This is a case of rampant caries that involves a lot of teeth together.
3. Habit removal appliances: We also provide habit-breaking appliances for children. Habits such as thumb sucking, lip biting etc can be treated at the dental clinic.
4. Fluoride applications: Fluorides have a great role in preventing caries. Regular application of fluoride helps to control caries. It also promotes remineralisation of the tooth. Fluoride treatments have specific benefit in preventing caries in children.
5. Management of facial traumas in children: Did you know that if your child loses a permanent tooth due to any trauma, it can be reimplanted to the same site again? Well we have saved a lot of such teeth by educating our patients.
6. Space maintainers: At times, the primary tooth cannot be saved. In such cases we have to extract the primary tooth. But by doing so, we also ensure that the space that has been created by extraction should saved for the underlying permanent tooth. For this purpose, space maintainers are given at the site where the extraction has been done. These are removed when the underlying permanent tooth starts erupting.