Managing Dental Disease in Children

Inspite of all the care , children end up getting dental disease. Poor food habits, bad brushing habits, overcrowding of teeth, deep fissures on the biting surface of the tooth makes a child at a higher risk for dental disease.

At Smayate dental clinic, we want to make your experience as pleasant and stress-free as possible in the event your child may need restorative work.

Fillings and crowns:

When children have decay or cavities and need fillings, we use white or tooth-colored fillings (either glass-ionomer or composite filling). If the fillings are large then we recommend to put a crown on the tooth as well. The choices of crowns are either stainless steel crowns or tooth coloured zirconia crowns. Both crowns are preformed crowns and are placed on the tooth in a single sitting. Both are extremely durable and the only difference is aesthetics.

Early damage being treated with zirconia crowns

Stainless steel crown
protect a tooth both
after root canal treatment
and large fillings.

Large filling in a baby tooth. Note the last tooth in the picture is a permanent molar which most parents don't even know that it is already in the mouth.

Pulp/Nerve treatments:

The structure of a baby tooth is much different than a permanent tooth. The outer layer of enamel is much thinner, so a cavity can become large rather quickly. If the decay becomes too large, it may expose the nerve tissue inside the tooth. This will require removal of a portion of the nerve (called a pulpotomy). If this is done, the tooth will need to be covered with a crown to cover the damaged tooth.

If the infection is more severe then root canal treatment is carried out. A pulpectomy (root canal treatment ) is carried out by the total removal of the pulp (nerve), of the infected/ abscessed tooth. A cap/crown is then placed on the tooth.

Extractions and space maintainers :

Sometimes, decay gets so large that the baby tooth gets infected. We have a choice to either save the tooth with a root canal treatment or simply extract the tooth. If the baby tooth had been extracted at an early age, we will want to hold the space with a Space maintainer. A space maintainer is a small appliance that simply holds the space open until the permanent tooth is ready to come in. If it is time for the permanent tooth to erupt then space-maintainers could be avoided.

Extraction
Section

Space Maintainer which saves space for an
unerupted tooth in a child.

Trauma/injury while playing also sometimes requires the tooth to be removed. Customised sports -guard is recommended to prevent such incidence of dental injuries.

Nitrous Oxide/Calm dentistry:

We understand that the little ones will have anxiety and fear of the going to a dentist. For the same reason we are able to offer Nitrous oxide (laughing gas) to calm them down. The parent is advised to give the child a light snack before the procedure and leave a two-hour gap between meal time and the dental procedure. This prevents any nausea and vomiting that the gas might rarely induce. In this Safe and Child - friendly form of Minimal Sedation, the child breathes laughing gas through a mask (nasal hood) on the nose during treatment and immediatately feels calm and relaxed. This technique does not put the child to sleep so the child continues to follow all the instructions and gets the dental treatment done. When the gas is turned off, the effect wears off very quickly. The child is given oxygen for a few minutes that flushes out the remaining gas.

Post treatment, children can return to their normal activities. However vigorous physical activities like skating, football, swimming etc can be postponed until the next day.