Root Canal Treatment in Children
Endodontic treatment in children is a treatment method applied in cases of inflammation or infection in the pulp tissue, which contains the nerves and blood vessels of the tooth, in deciduous teeth or newly erupted permanent teeth. It is similar to root canal treatment in adults, but it differs due to the structure and developmental characteristics of children’s teeth.
Why Is Endodontic Treatment Necessary in Children?
- Deep caries: When tooth decay reaches the nerve, pain and infection can occur.
- Trauma: Damage to the nerve can occur as a result of blows to the teeth.
- Tooth fractures: When tooth fractures reach the nerve, the risk of infection increases.
The Importance of Endodontic Treatment in Children
- Prevents tooth loss: Untreated teeth can be lost due to infection. When applied to a permanent tooth, extraction of the tooth is prevented and root development is ensured to continue. Deciduous teeth are preserved in the mouth as a natural space maintainer.
- Protects neighboring teeth: Infection can spread to neighboring teeth.
- Protects children’s oral health: Healthy teeth are important for chewing, speaking and aesthetics. The child’s chewing and speaking functions are preserved.
Endodontic Treatment Methods in Children
Endodontic treatment methods in children may vary depending on the age of the tooth, the condition of the infection, and the general condition of the patient. In general, the following methods are used:
Direct and Indirect Pulp Capping
If the caries is not very deep, a protective layer is created on the nerve. If the caries is a little deeper, a temporary covering is placed on the nerve and then a permanent filling is done.
Amputation (Pulpotomy) in Children
Amputation is a dental treatment usually applied as a result of the progression of caries in deciduous teeth. In this procedure, the nerves and vessels of the decayed tooth are removed and the remaining healthy part is tried to be preserved. Amputation, among the public, is also known as “small root canal treatment” or “children’s root canal.” The upper part of the nerve is removed and the remaining part is treated with medication.
Why Is Amputation Performed?
- Progression of caries: When caries progresses into the tooth and reaches the nerves, amputation may be necessary. In this way, a tooth that needs to be extracted remains in the mouth for a while. There is no tooth space until the permanent tooth erupts. Deciduous teeth are preserved in the mouth as a natural space maintainer. The child’s chewing and speaking functions are preserved. When applied to a permanent tooth, extraction of the tooth is prevented and root development continues.
- Reducing the risk of infection: Infection caused by caries can spread to other teeth. Amputation reduces this risk and prevents the spread of infection to other teeth.
How Is Amputation Performed?
The tooth is numbed with local anesthesia and a rubber dam is placed to protect it from saliva during the procedure. The carious tissues in the tooth are cleaned. Only the infected pulp tissue in the crown part of the tooth is removed with special instruments. Biocompatible drugs (for example, calcium hydroxide, MTA or formocresol) are applied to protect the root pulp. The tooth is usually covered with a stainless steel crown or a suitable filling material.
Root Canal Treatment in Children
Root canal treatment in children, as in adults, is applied in cases where tooth decay progresses and reaches the nerve of the tooth. However, since the structure and growth processes of children’s teeth are different, the approach to treatment is also different. In short, root canal treatment is applied in cases of pulp infection or necrosis in deciduous or young permanent teeth. Here, all infected or dead pulp tissue is removed and the root canals are filled to ensure that the tooth continues to function.
Situations That Cause Root Canal Treatment in Children
- Deep caries: If tooth decay is not treated in time, it reaches the inner part of the tooth (pulp) and root canals and causes infection.
- Dental traumas: Damage may occur in the nerves of the tooth as a result of blows to the tooth.
- Tooth fractures: Fractures in the tooth can lead to infection of the pulp.
- Tooth abscess: In abscessed deciduous teeth. It is an inflammatory condition that occurs in or around the tooth.
- In cases of necrosis or infection in young permanent teeth.
Symptoms of Root Canal Treatment in Children
- Severe toothache: Especially sensitivity to hot or cold food and drinks.
- Swelling in the tooth: Swelling may occur around the tooth or in the gums.
- Facial swelling: Sometimes the infection can cause swelling on one side of the face.
- Fever: Fever may occur if the infection spreads.
- Bad smell: There may be a bad taste or smell in the mouth.
How Is Root Canal Treatment Performed in Children?
The tooth is numbed with local anesthesia and a rubber dam is applied to prevent contamination with saliva. The carious tissues and infected pulp in the tooth are completely cleaned. The infected or dead pulp tissue in the root canals of the tooth is removed with special instruments. The canals are disinfected (for example, with 2.5–5% sodium hypochlorite).
In deciduous teeth, the root canals are filled with resorbable filling materials (for example, iodoform pastes, calcium hydroxide-containing substances). In permanent teeth, it is filled with permanent materials such as gutta percha. Deciduous teeth are usually restored with stainless steel crowns. Permanent teeth are completed with composite or ceramic fillings.
Advantages of Root Canal Treatment
- Thanks to root canal treatment, the infected tooth can be treated without extraction.
- The chewing and aesthetic functions of the child are preserved.
- Supports the continuation of root development in permanent teeth.
- Eliminates infection-related pain.
- Protects the child’s general health. Prevents the spread of infection to other parts of the body.
Result: Amputation and root canal treatment allow the restoration of teeth damaged by caries or trauma. The child’s age, the condition of the tooth, and the spread of infection are decisive in the selection of these treatments. Both treatments aim to keep the tooth in the mouth, thus preserving the child’s chewing, speaking and aesthetic functions.
Regular brushing and flossing are important after treatment. Regular check-ups should be performed by the dentist. Early diagnosis and treatment is the best way to protect your child’s dental health.