Root canal treatment is a safe and effective way to stop many kinds of tooth pain, and to keep a tooth from being lost due to decay or injury. But if a root canal is recommended for your young child, you may wonder why: Isn’t that baby tooth going to fall out in a few years anyway?
That’s true — the primary (baby) teeth typically are shed between the ages of 6 and 12 years. Yet there are some good reasons for trying to save baby teeth for as long as possible with root canal treatment, rather than simply extracting any that are damaged by trauma or infection.
For one, primary teeth have the same functions as adult teeth — and a missing tooth at any age can cause problems with speech and eating. Baby teeth also have another important role: They serve as guides for the proper placement of the permanent teeth. Without primary teeth to guide them in, permanent teeth tend to emerge in a crooked fashion, often becoming tilted or crowded because of inadequate space. This can result in bite problems that may require extensive orthodontic treatment later.
Saving The Tooth Is Always Best
Unlike its hard outer surface, the soft pulp inside the tooth is rich in blood vessels and nerves. Problems in this area are often signaled by tooth sensitivity and pain. When these symptoms occur, radiographs (x-rays) are often necessary to confirm that the pulp is diseased, or dying. That’s when treatment is needed, before an abscess or further infection can develop.
In severe cases, the tooth may need to be removed, and a space maintainer installed to fill the gap. But many times, space maintainers don’t fully restore the tooth’s functionality. Plus, they are susceptible to coming loose and must be monitored constantly. If possible, other treatment methods are preferred, such as:
- Indirect pulp treatment. If pulp damage is minimal, it’s possible to remove most of the decay (but not the pulp), apply an antibiotic, and then seal the tooth up again; that’s referred to as an “indirect” treatment.
- Pulpotomy. Alternatively, if decay is limited to the upper portion of the pulp, we may recommend a “pulpotomy.” This involves removing the damaged part of the pulp, stabilizing the remaining healthy portion, and then disinfecting and sealing the tooth. This “partial” root canal is a time-tested technique that’s successful in many cases.
- Pulpectomy. If pulp tissue is infected through the entire tooth structure, a pulpectomy may be needed, which requires the removal of all pulp tissue. The canals are then disinfected, shaped, then filled and sealed with inert material. Afterwards, the crown (visible part) of the tooth will be restored. This resembles traditional root canal therapy, with a crucial difference: The sealant we use in children is capable of being dissolved by the body. That way, when it’s time for a permanent tooth to erupt, the baby tooth’s roots can be naturally absorbed and tooth development can proceed normally.
Endodontic Treatment
The old gag line “I’d rather have a root canal” may still get a laugh — but root canal problems are no joke. It’s important to remember that root canal treatment doesn’t cause pain; it relieves pain. A typical root canal procedure is performed with local anesthetics, and doesn’t cause any more discomfort than having a filling. Here’s what to expect:
First, you will receive anesthesia (usually a numbing shot) — and for many patients, the worst is now over. Next, a small opening is made in the tooth surface to give access to the pulp chamber and root canals. Then, tiny instruments are used — often with the aid of a microscope — to remove dead and dying tissue from inside the narrow passages. These passages are then cleaned, disinfected, and filled with a safe, inert material. Finally, the opening in the tooth is sealed to prevent contamination.
Other endodontic treatments may be recommended for removing sources of infection and preventing future problems. Following an endodontic procedure, it may be necessary to have a restoration (such as a crown) placed on the tooth to restore it to full function and aesthetic appearance. After that, with proper care the restored tooth should last for many years.
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