|
Fixing cavities and performing minor oral surgeries on children require finesse and an understanding of the special needs of children. It requires a staff who loves children and a team who is patient with children. We offer that kind of service. Routine fillings and sealants are provided. Stainless steel crowns are often ideal restorations for deciduous teeth and sometimes for young permanent teeth. Abscessed teeth are a special challenge for kids. Some of our restorative and surgical procedures are listed and discussed below.
Fillings and/or Sealants
Small cavities and sealants do not require numbing with local anesthesia. We like to use nitrous oxide gas to relieve some of the pain and give your child a pleasant experience. If the cavities are deep, local anesthesia is used.
Stainless Steel Crowns
This is often the best treatment available. Where there are multiple cavities on the same tooth or where the cavities are in inaccessible areas between the teeth, this is a very durable restoration.
In preparing the tooth for a crown, all the decay is removed. It is then checked to ensure the decay has not reached the sensitive pulp tissue in the inner part of the tooth.
Your child may need a pulpotomy procedure along with the crown. This is when the pulp tissue is removed and the root canals are treated to kill all bacteria and prevent later infection.
Usually a tooth with a stainless steel crown will never need any further treatment. Deciduous teeth with crowns will naturally fall out at its appointed time, the crown coming out with the tooth. Occasionally, a tooth with a crown will become abscessed and will need to be removed or the crown may come off and have to be re-cemented. Or the child may grind a hole in the top of it, and have to be repaired or replaced. However, all these problems are rare.
A stainless steel crown is placed on a permanent tooth only when the tooth has extensive decay or when the tooth has poorly formed enamel. In such a case, the decay will be removed, and the health of the inner part of the tooth is then assessed. If the decay is very deep, the tooth may need a root canal filling or other treatment. You will be advised of the situation at the time the tooth is fixed. This type of restoration is intended to last about 10 years. Later in life your child will need a cast metal crown, usually with a porcelain veneer, which is more suitable for the adult dentition. These are much more expensive and require more elaborate dental work.
Root Canal Filling
Abscessed deciduous teeth are usually removed. But infected permanent teeth are often best saved by root canal therapy. Yet a root canal procedure requires mature roots that taper to a small apex. Developing teeth often have immature roots and root canals cannot be done immediately. A procedure called, “apexification” is sometimes needed. It involves removing the tissue and infection in the root canal chamber. The canal is then filled with some material that encourages root end closure. While it may be necessary to repeat this several times at 3-6 month intervals, the procedure only takes a few minutes. Since we specialize in care for maturing teeth, we can evaluate what best option your child has in treating the problem.
Root canal fillings are done on permanent teeth which are abscessed. In times past abscessed teeth had to be taken out. Now, root canal fillings allow us to preserve the teeth. The procedure involves removing the soft tissues and infection in the inner chamber of the tooth and filling this chamber down into the root. The tooth then must be restored, usually with a crown on a back tooth and with a white filling on a front tooth.
The success rate for a root canal treatment is about 95 percent. If the treatment fails, the tooth will have to be removed to prevent infection in the jaw bone. Some teeth cannot be fixed this way because of internal anatomy and accessibility problems.
Tooth Removal
Deciduous teeth are removed when they are abscessed. Permanent teeth that are abscessed can usually be fixed by root canal therapy. Others are too badly decayed and cannot be restored. Deciduous teeth that are decayed but not yet abscessed can be removed to prevent an infection. This is often done because the teeth will soon be lost anyway. Some teeth are removed to prevent or alleviate crowding. Some teeth are removed because they are impacted or otherwise cannot erupt properly. Some children have extra teeth that are best removed to give a pretty smile. Sometimes the deciduous teeth do not come out to make room for the permanent teeth. These teeth should be removed.
Frenectomy
A frenum is a ligament that attaches the lip or the cheek or the tongue to the jaw bone. An enlarged frenum can cause problems. A large lingual frenum can cause a person to be tongue tied and develop poor speech articulation. It can also pull the gums away from the teeth. A large labial frenum can make a gap between the upper incisors. Removing the ligaments can improve speech, provide healthier gum tissues and allow front teeth to move together. We usually remove the ligament with electro-surgery. During surgery there is little bleeding, and gas and local anesthesia are used to help calm your child and numb pain. Most parents are very pleased with the results.
|
