Primary teeth are extremely important for the child’s physical and mental development. Early childhood caries has become a growing problem due to its widespread occurrence and rapid progression. Consequently, in addition to restorative care of deciduous teeth, endodontic procedures in the primary dentition are among the most common types of work in pediatric dentistry.
Deciduous teeth endodontics is aimed at curing diseases of deciduous teeth and preserving them until they fall out naturally.
The primary teeth are so important
As placeholders for the permanent teeth, the primary teeth have an important role for the child and its development. If new teeth no longer have a predefined place because the primary tooth falls out too early (exfoliation), the surrounding primary teeth shift, or another permanent tooth moves in an unforeseen direction. This interacts in many ways with incorrect chewing and malocclusion of the jaw, each of which is an attempt by the child to compensate for the gap that has occurred. In addition, there is the danger that a bacterial infection of the primary tooth can spread to the tooth growing underneath.
For the future of the child, all this means further interventions by the dentist that could have been avoided. In addition to the time, nerves and money that this costs, healthy primary teeth are also essential for the child's psychological development. For good speech development, it is dependent on a functioning set of primary teeth and, as with adults, natural and beautiful teeth influence the way others treat us.
What are endodontic measures?
In the event of bacterial infection of the root of the deciduous tooth, for example due to caries, the question arises as to whether and how the health of the tooth can be restored. In recent years, pediatric dentistry in particular has increasingly become the focus of research. Thus, the preservation of the deciduous dentition and its natural exfoliation (falling out of the tooth) has nowadays a much higher priority than in the past. Endodontic measures are interventions that deal precisely with this, i.e., the healing of the tooth root.
When is endodontic treatment necessary?
If the development of the dentition is correspondingly advanced, extraction of the primary tooth may be an option. The basis for this decision would be, for example, that the permanent tooth is already coming in and no consequential damage can be assumed. Otherwise, the most important goal of the various treatment options is the definitive coronal restoration of the deciduous tooth, i.e., a complete bacterial closure with an equally stable denture. Which therapy concept and which materials are chosen depends, of course, on the individual damage pattern, as well as the overall situation and possible late effects. Equally important, of course, is the child itself. Depending on the child's age and stage of development, there are different possibilities for cooperation, recommending one form of therapy or excluding another.
The forms of therapy at a glance
The filling is recommended for minor damage and, as a standard procedure, is also quick and inexpensive to perform. Normally, silver-gray amalgam can be used, since the focus is less on esthetics and more on preserving the deciduous tooth in its role as a space maintainer for the permanent tooth. In the case of more serious damage, crowning, usually with stainless steel, has become the preferred method for this very reason. For example, in the case of a pulp amputation. Other recommended materials and therapeutic solutions are MTA (mineral trioxide aggregate), which is similar in color to the tooth, or composite fillings in individual cases. Whereas adhesive systems (chemical pretreatment of the tooth for better retention of the prosthesis) have received a great deal of precedence, temporary filling materials have nowadays been largely replaced by the above-mentioned procedures due to poorer results.
