Pediatric dentistry

Toothache (Pulpitis) in Children

Pulpitis in children - treatment

A toothache (pulpitis) is when the pulp inside a tooth becomes inflamed and infected. The pulp is the soft part inside the tooth that has blood vessels and nerves.

The most common cause of pulpitis is tooth decay, and the second most common cause is injury. Mild inflammation, if relieved, may not damage the tooth permanently. Severe inflammation may cause the pulp to die.

Pulpitis may lead to infection, in which a pocket of pus (periapical abscess) develops at the root of the tooth. An untreated infection in a tooth may spread to the jaw or to other areas of the body (such as the brain or sinuses).

What causes a toothache in a child?

A toothache often happens after an injury to the tooth. The most common form of injury to a tooth is from a cavity. This is a hole in a tooth.

A cavity is often the result of poor dental hygiene. Sugar and starch in foods allow bacteria in the mouth to damage the teeth. The bacteria in the mouth feed on sugar and starch and make an acid that can eat through the teeth. This leads to tooth decay.

What are the symptoms of a toothache in a child?

Each child may feel symptoms a bit differently. But below are the most common symptoms of a toothache:

  • Constant, throbbing pain in a tooth
  • Pain in the tooth that gets worse when the tooth is touched
  • Pain in the tooth that gets worse with hot or cold foods or liquids
  • A sore, tender jaw around the tooth
  • Fever
  • Generally tired and feeling badly (malaise)

How is a toothache diagnosed in a child?

Your child’s healthcare provider can often diagnose a toothache with a complete health history and exam of your child. He or she will likely refer your child to a dentist for evaluation and care.

At the dentist, your child may have X-rays done. An X-ray makes images of internal tissues, bones, and teeth. The dentist may also check for cavities using a device called a transilluminator. It uses no radiation.

Chronic pulpitisThe symptoms of a toothache may seem like other health or dental problems. Make sure your child sees his or her healthcare provider or dentist for a diagnosis.

To determine whether the pulp is healthy enough to save, dentists can do certain tests. For example, dentists can apply a hot, sweet, or cold stimulus. If the pain goes away within 1 to 2 seconds after the stimulus is removed, the pulp may be healthy enough to be saved (called reversible pulpitis). If pain persists after the stimulus is removed or if pain occurs spontaneously, the pulp may not be healthy enough to save (called irreversible pulpitis).

Dentists may also use an electric pulp tester, which indicates whether the pulp is alive but not whether it is healthy. If the person feels the small electrical charge delivered to the tooth, the pulp is alive. Sensitivity to tapping on a tooth often means that inflammation has spread to the surrounding tissues. Doctors sometimes do x-rays to determine how far the inflammation has extended and to help rule out other disorders.

How is a toothache treated in a child?

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is. Treatment may include:

  • Antibiotics
  • Pain medicine
  • Warm saltwater rinses for the mouth
  • Tooth removal
  • Draining of an abscess, if needed
  • Root canal. This is surgery that removes the inflamed pulp from the middle of the tooth.

If the infection is severe, your child may be treated in a hospital. He or she may need antibiotics through an IV (intravenous) tube.

In reversible pulpitis, pain and inflammation go away after dentists remove any decay (cavities) and then restore the tooth. When pulpitis is detected early, dentists sometimes place a temporary filling containing a sedative that can eliminate the pain. This filling can be left in place for 6 to 8 weeks and then replaced with a permanent filling. Most often, dentists place a permanent filling immediately.

In ;irreversible pulpitis, pulp damage is extensive and cannot be reversed. The only way dentists can stop the pain is by removing the pulp via root canal treatment or tooth removal (extraction). If people have other signs of infection (such as a fever), dentists give antibiotics taken by mouth. Sometimes root canal treatment is repeated if the symptoms do not go away or worsen.

Features of treatment

The correct treatment of pulpitis in children preserves the integrity of milk teeth. The main goal is to remove the inflamed tissue. And the difficulty of achieving that without harming the dentist is able to remove only the coronal part of the pulp. Deep part can be removed when the roots are developed to the end, but even in this case, it is likely to hurt the rudiments of the permanent teeth and damage tissues nearby.

As the mechanical action on the pulp quite painful, the treatment is conducted under anesthesia. The type of selected individually, depending on the health of the child, his emotional state and age.
Pulpitis baby tooth can be treated conservatively or surgically. Conservative methods aimed at preserving the tissues affected by inflammation. In the surgical treatment removes all the pulp or part of it.

Conservative method

Conservative treatment of pulpitis of deciduous teeth used in the early stage of the disease in the acute form of the flow with partial inflammation of the tissues, and when the exposure of the arch of the dental cavity as a result of injury. In the process of treatment, the doctor cleans a cavity of dead tissue. After that, he treats her with antiseptic solutions (furatsilina, chlorhexidine), imposes a medicated paste. Filling the cavity is performed using a high-tech fillers and safe and designed for children.

After the primary stage of treatment the doctor prescribes a course of physical therapy consisting of sessions electrophoresis. During the procedure introduced into the body in the medicinal substance with the help of impact shock. Electrophoresis involves the use of special drugs that are able to decompose into ions and purposefully accumulate in requiring treatment of the body. This procedure is recommended not only for treatment of pulpitis, but for the treatment of periodontitis of deciduous teeth in children, caries, alveolitis, etc.

Electrophoresis is a painless procedure that allows to effectively remove the inflammation, bactericidal influence of the tissues, preventing the development of infection. Drugs aktiviziruyutsya directly in the hearth of the disease, it significantly accelerates the healing process.

Operational method

When the inflammation penetrates deep into the tissue, for removal of infectious focus used surgery. It can be of two types: with amputation pulp is cut out partially, and hysterectomy.

The doctor performs the following algorithm:

  • enters anesthesia and devitalized pulp;
  • reveals and dissects a cavity;
  • conducting amputation or extirpation of the pulp
  • applies antiseptic preparations for processing textiles;
  • uses medical drug;
  • sealed tubules;
  • sealing the tooth.

When the formation of the root system is complete, most often for the treatment of pulpitis of primary teeth used by vital extirpation. The pulp is completely removed and the canals are filled with resorbable sealing compound.

Treatment of pulpitis of deciduous teethDentists have always focused on the healthy development of the rudiments of permanent teeth. Therefore, they try to leave the pulp in the viable state, because it connects blood vessels and nerve fibers to the tooth. Vital and devital partial removal techniques that maintain pulp.

Vital amputation is the removal of inflamed pulp under the crown, and the preservation of its root base. Due to this, the tooth can develop. The method considered optimal for treatment of the disease during the development of the roots. The pulp remains functional, despite the removal of the coronal part. Then the wound will be sutured treatment paste. The doctor’s visit is recommended within 4 months after surgery. And then every six months.

Necrotization pulp and imposing on it a special ARSENICAL paste operating for about two days, called devital amputation. The entire pulp is removed and the cavity is filled with a therapeutic paste, mummifying the remains of the fabric. This blocks the possible development of bacteria. This treatment is widely used in pediatric dentistry, because deleting nekrotizirovannah pulp painless and does not cause the child unnecessary emotions.

Periodontitis in children have not develops after devital amputation, but this method complicates the eruption of permanent teeth. For this reason, a dairy with a sealed tubules after some time to remove. Devital amputation is used with pulpitis of permanent teeth in case of problems with the introduction of an anesthetic, and in those situations when you need to quickly eliminate the inflammation and acute pain.

Inflammation of the pulp, the child is not an indication for tooth extraction. But it is important to timely identify the disease and seek medical help. At unskilled approach to treatment, you can lose a tooth or worse still, cause the destruction of a germ molar. Prevention of pulpitis is regular visits to the dentist, treatment of caries in the early stages, the hygiene of the oral cavity.

Modern medicine can offer several methods of treatment of pulpitis, but universal among them.

Only a qualified dentist will select the best option given the course of the disease and characteristics of the child.

How can I help prevent a toothache in my child?

Good oral habits can prevent cavities, the leading reason for a toothache. Make sure your child:

  • Brushes his or her teeth twice a day
  • Flosses daily
  • Sees the dentist regularly. The dentist can find and treat cavities early before they cause damage to the pulp. He or she can also give treatments to stop cavities from happening.
  • Eats healthy foods, limiting those high in sugar and starch

Key points about a toothache in children

  • A toothache is when the pulp inside a tooth becomes inflamed and infected.
  • Most toothaches are caused by cavities.
  • Besides pain, a toothache may cause fever and malaise.
  • X-rays can diagnose a toothache.
  • Treatment may include antibiotics, pain medicine, and removal of the tooth.
  • Toothaches can be prevented with good oral care.

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

  • Know the reason for the visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.
  • Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.
  • Ask if your child’s condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if your child does not take the medicine or have the test or procedure.
  • If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.

Reviewed by the QSota Medical Advisory Board