Endodontic Treatments for Children
Endodontic treatments are typically done on adult teeth. However, there are 3 forms of treatments performed on baby teeth. The first is apexogenesis, which is when the pulp is healthy enough to work with for the procedure. Apexification is treatment performed when the pulp is not healthy and can’t be saved. And, the 3rd option is extraction, when the first two are no longer an option.
Even though they are baby teeth, it is very important to maintain our teeth for as long as possible, regardless of age. This is all the more critical for maturing children, so we are equipped and ready to take care of your child, comfortably and effectively.
Most teeth in children are completely formed. So, they can be cared for with standard endodontic treatment. There is the exception though, and a tooth could require some root canal treatments before the root fully develops. The following are 3 examples:
In order to promote continued root development, apexogenesis is the procedure recommended for children. Applying a medication during this procedure encourages the pulp tissue to remain at its healthiest, and allows for the tooth to be sealed. This will help to prevent infection, as well as enables the root to form properly. The apex, which is the root tip, will gradually seal while the root canal walls thicken while the child continues to age. If the pulp remains healthy, the child might not need further treatment for many years. Ultimately, the tooth stands a better chance, the more the root matures.
There are 4 forms of vital pulp treatment for baby teeth:
- Protective Base – If there is decay found in the tooth, yet the pulp is still healthy, a protective base is a viable option. Once the decay is removed from the tooth, a protective material is positioned in the tooth, before the filling is placed.
- Indirect Pulp Cap – If the decay comes close to the pulp, yet hasn’t reached it quite yet, indirect pulp cap is an option used quite often. After the decay is eradicated, a protective dressing is applied over the decayed area near the pulp. As a result, the pulp is no longer exposed. This can also stimulate the healing process. At this point, a filling is performed.
- Direct Pulp Cap – If a portion of the pulp has become exposed, the direct pulp treatment is used. The exposed pulp is treated with medicine. However, this option works better in adult teeth, than it does in baby teeth.
- Vital Pulpotomy – If the pulp has evidence of decay, yet the root is still viable and healthy, a vital pulpotomy can be performed. The decay and unhealthy pulp is removed, leaving the healthy pulp intact. A protective material fills the tooth, and it’s covered with a crown. While vital pulpotomy is typically used in children, it can also be used in an adult tooth that has not finished growing a full root. Although, when used in an adult tooth, it’s often temporary, until the root is fully grown.
Apexification is when the root hasn’t fully matured, and its pulp tissue needs to be entirely eradicated because it’s not healthy and could become infected. The tooth can remain, if the endodontist applies a medication onto the root, which will aid in forming a barrier of hard tissue, near the root tip, which provides a firm base for a root canal filling. When this happens, the walls of the root canal will not fully develop, creating a more susceptible environment for future tooth fractures. So, it’s vital for the teeth to be appropriately restored by the endodontist.
This root canal therapy allows the doctor to facilitate regeneration of healthy pulp tissue in a root not fully developed, where the original pulp had been infected or damaged. When successful, it allows for growth of new and healthy pulp tissue that will promote continued root development. As with Apexification, it requires placement of medication within the canal, and a period of monitoring for root development. If the root fully forms, the tooth will be stronger and more functional, and further endodontic treatment may be avoided for years to come.