Treatment of caries and pulpitis for children under 14 years of age and adolescents

According to statistics, caries occurs more often in children than in adults. This is one of the most common reasons for visiting a dentist, because not only permanent teeth, but also baby teeth are susceptible to destruction.

Children do not like to be treated, and often parents feel sorry for the child until the last moment and do not take him to the dentist in order to avoid stressful situations. But you need to understand that the health of his teeth in adulthood will depend on how they care for their baby’s oral cavity in childhood.

Features of superficial caries

Among the main distinctive features of superficial carious damage to teeth in children in comparison with other forms of pathologies, the following should be noted:

only the enamel layer is affected by pathogenic formations. The dentin remains intact. With timely treatment, the risks of complications are minimal;
the occurrence of an acute reaction to external stimuli, for example, sour and sweet foods, low and high temperatures;
if superficial caries is diagnosed in children, treatment can be carried out without tissue preparation;
Most often, the superficial form occurs in children aged 3-4 years and in adolescents.

Note! Initial caries and superficial caries are two completely different forms. The first appears as a small spot, the second occurs in the absence of treatment. It can be recognized by the presence of small-sized carious cavities.

What are caries and pulpitis?

Caries is a disease in which the hard tissues of the tooth are destroyed due to the loss of minerals from the tooth enamel.
How and why caries forms, read our article on the treatment of caries. The carious process, progressing, gradually reaches the pulp chamber, in which there is a neurovascular bundle of fibers that nourishes the tooth - the pulp, and destroys it. Bacteria from the carious cavity penetrate inside, infect the pulp, it becomes inflamed and pulpitis begins.

Both adults and children suffer from caries and pulpitis, but the course of the disease at different ages and its treatment differ.

Read about the treatment of caries and pulpitis in adults and pulpitis in baby teeth in the sections dedicated to these topics. In this article we will tell you about the treatment of caries and, especially, pulpitis of permanent teeth in adolescents, as well as about its features.

Symptoms of the disease

Symptoms of superficial foci of caries are manifested by the following signs:

visible defect. On the surface of the tooth there is a small cavity with uneven edges. The color of the formation is dark, the bottom is slightly rough;
pain syndrome. When exposed to cold, hot, sweet and sour foods or drinks, sharp short-term pain occurs;
hyperesthesia. When inhaling cold air, while brushing your teeth, increased sensitivity occurs.

These are the main symptoms and in each individual case they can manifest themselves differently.

How is pain relief performed when treating pulpitis in adolescents under 14 years of age?

Pulpitis is often accompanied by severe pain, so high-quality and safe pain relief is especially important for effective treatment and comfortable well-being of the patient.

Treatment of pulpitis in children is carried out completely without pain, for this purpose local conduction anesthesia is used. For severe pain, it is combined with intrapulpal anesthesia.

To prevent a child from having a negative reaction to an injection of an anesthetic drug, in our clinic we use local application gel anesthesia (freezing).

If there is increased anxiety, preliminary sedation is recommended; before visiting the dentist, the child can be given light sedatives - valerian, Novopassit, motherwort tincture, according to the instructions and in the dosage indicated for his age/weight.

Factors influencing the development of superficial caries in children

The fundamental factors that result in superficial caries in children are:

eating foods that contain large amounts of carbohydrates;
non-compliance with hygiene rules: insufficient brushing of teeth, ignoring periodic rinsing with special means, etc.;
drinking water with a deficiency of fluoride in its composition;
deficiency of vitamins and mineral elements;
severe systemic diseases;
hormonal imbalance;
ignoring professional hygiene, the need for which arises every 5-6 months.

Any of these factors or several at once are the primary causes of tooth enamel destruction.

The Forbidden fruit is sweet…

In order not to tempt your baby with “forbidden fruits,” simply do not buy them or consume them yourself. There is no doubt that your friends and relatives all bring sweets to the child solely with the best intentions. Try to talk to them and explain that instead of candy, you can bring your child, for example, a toy or an interesting book. Due to poor or complete lack of oral hygiene, the plaque that remains on the teeth after eating food turns into dental plaque containing bacteria that produce lactic acid, which damages the enamel and contributes to the development of caries. As soon as a child has his first teeth, he should immediately have age-appropriate toothpaste and a brush. Developing the habit of brushing your teeth at an early age twice a day (in the morning and also in the evening, after meals) will prevent many problems.

Principles of treatment of superficial caries

When superficial caries is detected in children, treatment should be aimed not only at eliminating formations on the tooth enamel, but also at preventing the re-development of the pathology. To prevent complications, comprehensive and immediate therapy is necessary.

When talking about treatment, it should be understood that it is just beginning in the dentist’s office, and it will also need to be continued at home using special means and traditional medicine recipes.

Features of treatment in the pediatric dentist's office

If baby teeth are damaged by caries, then it is quite possible to treat them conservatively without the use of drills, which almost every child is afraid of. Modern dentistry offers more gentle and comfortable methods:

Children under 3 years of age undergo silvering or deep fluoridation of their teeth. If the enamel has already been damaged by caries, it is cleaned of plaque and treated with a laser. If necessary, cracks in the chewing and frontal teeth are sealed;
at the age of 3 to 5 years, ozone therapy can be performed to eliminate the first stage of superficial caries, and in case of major complications, treatment is carried out using the method of depophoresis. Its essence lies in the introduction directly into the root canals of a special composition with calcium and copper;
Children from 5 to 9 years old undergo filling. Glass ionopolymers or colored compomers are used for fillings;
Children aged 9 to 12 years already have molars and adult technologies can be used to treat them with minimal trauma. But in most cases, therapy of chewing teeth is carried out by sealing fissures.

When superficial caries in children requires complex dental procedures, local anesthesia is mandatory before such procedures are performed. If removal is necessary, such an intervention can be performed under intravenous anesthesia.

Treatment at home

Along with professional treatment of caries by a pediatric dentist, proper oral care at home will also be required to obtain an effective result. For this purpose, special rinsing compositions and toothpastes with anti-caries effects are used.

For children under 4 years of age, dental and oral care products should not contain fluoride. The therapeutic effect is provided by antibacterial active components and calcium ions.

Children over 4 years old are allowed hygiene products containing fluoride, only the concentration of the element must be minimal.

LACALUT kids, PresiDENT Baby, SILPA Putzi, Splat junior are considered good toothpastes for children. You need to brush your teeth with them twice every day. Among the rinses, Drakosha for children, Active Kids, and LACALUT Teens have proven themselves well. When treating caries with such solutions, it is necessary to rinse your mouth after every meal and always before going to bed.

In addition to professional medications, you can also use remedies prepared according to alternative medicine recipes:

An infusion of chamomile is perfect as a rinse. To do this, pour a glass of boiling water into 1 tbsp. l. dried flowers, leave and cool to room temperature;
a weakly concentrated solution of sea salt has a positive effect on the condition of teeth. Dissolve 0.5 teaspoons of salt in a glass of water and use for rinsing.

Important! Rinse aids can only be used after the child reaches 1.5-2 years of age, when he can already rinse and spit out liquid on his own, rather than swallow it.

Can a filling be placed on a baby tooth?

If the doctor diagnoses not the first stage of tooth decay and insists that it is necessary to put a filling, it is better to agree with him. This is the fastest and most reliable way to solve the problem of infection and protect permanent teeth.

Modern filling materials are as safe as possible for children’s teeth. Depending on the stage of caries, the doctor will select a suitable filling option. Before installing a permanent filling, the dentist may place a temporary filling for several days to fix the medication inside the diseased tooth.

If the damage is not yet serious, the doctor will limit himself to preventive measures. There are different approaches and tools for different problems.

Possible complications

Some parents are in no hurry to visit a pediatric dentist because they consider it useless to treat baby teeth. This approach is explained by the fact that permanent ones will grow instead of them anyway.

Although the carious process itself does not transfer from baby teeth to permanent ones, untreated caries lesions have a detrimental effect on the condition of the latter. If you ignore superficial caries in children , complications may very soon manifest themselves:

caries progresses rapidly in the absence of adequate therapy. This leads to the development of periodontitis and damage to the molar tooth germ. The inflammatory process significantly slows down the eruption of permanent teeth and complicates their growth;
premature loss of baby teeth leads to the formation of malocclusion and disrupts the structure of the maxillofacial system;
If at least one tooth is missing in the dentition, this complicates the process of chewing food. As a result, problems arise with the functioning of the digestive system.

Remember! Even the smallest stain can lead to complete tooth decay. There is no need to risk your child's health. It is much easier to visit the dentist and, if necessary, treat caries.

Is it necessary to treat caries of baby teeth?

Despite the “temporary nature” of children’s teeth, treatment and care for them must be thorough and complete. Chronic inflammation in the oral cavity leads to serious problems.

A baby tooth affected by caries can decay so deeply that it affects the germ of a permanent tooth. The infection will spread to it, and it will grow up with enamel defects or simply die.
When a baby tooth is removed, the adjacent tooth moves into its place, causing the permanent tooth to erupt in a different place than intended. As a result, the bite is formed incorrectly, and in the future it has to be corrected with braces.
Advanced caries reduces immunity and causes ENT diseases and even allergies.
Painful sensations prevent the baby from biting and chewing food correctly, which causes digestive problems.
The child will be embarrassed about his bad teeth, which will prevent him from communicating with his peers.

It is necessary to treat caries at any age at the initial stage, and it is better to accustom your child to this in advance.

Stay vigilant

If you find plaque forming on your child’s teeth that you are unable to remove on your own, as well as brown or white spots, this indicates that the child urgently needs to be shown to a pediatric dentist. If the baby complains of discomfort that occurs when eating hot or cold food, this indicates the spread of caries into the deeper layers of the tooth. Parents should never ignore such complaints. It happens that a small child is not able to clearly communicate what is bothering him, so if he refuses food or a certain type of food, and also chews on one side, this may indicate toothache.

What is the danger of multiple caries?

Many parents believe that it is not necessary to carefully monitor baby teeth: they say, they will fall out anyway. They instill this attitude towards dental health into the child, without paying special attention to oral hygiene. But doctors know: the health of permanent teeth directly depends on the health of baby teeth. If caries is not treated, the infection will spread to their beginnings in the gums.

There are many negative aspects associated with caries:

discomfort in the teeth when chewing food;
reaction to cold, hot, sour foods;
frequent occurrence of colds and infectious diseases.

When teeth are inflamed, the child’s body is more susceptible to other ailments, leading to weakened immunity and stress on vital organs, because everything inside us is interconnected. Therefore, parents of young children should be especially careful about the health of their baby teeth.

Diagnosis of multiple caries

If the above-described symptoms appear in a child’s oral cavity, parents should definitely visit a doctor with him. Even if the dark spot is small in appearance, there may be a large carious cavity underneath it.

The specialist will examine the dentition and take measures to confirm or deny the diagnosis. For this, a dental mirror and probe are sufficient.

If necessary, the doctor will order an x-ray or use the transillumination method: using bright light to highlight dark carious cavities inside the teeth. If multiple caries is confirmed in a child, a number of therapeutic measures are prescribed.