Pulpitis is a disease of tooth tissue that is inflammatory in nature. Usually it develops against the backdrop of improper treatment. This pathology is encountered not only by adults, but also by children. From the materials in this article you will learn the causes of the disease, as well as its forms and basic treatment methods.
Pulpitis of the tooth - what is it?
Pulp is a neurovascular bundle of a tooth. As a result of the penetration of pathogens into this area, the inflammatory process develops. The disease often occurs as a complication of caries or is the result of improper treatment (poor quality fillings, periodontal surgery, tooth turning).
Pulpitis is one of the most frequent complaints of patients in dental clinics and is simultaneously considered a fairly common disease of primary teeth. In this article, we will dwell in more detail on the manifestations of this ailment in young patients, and talk about the most effective methods of treatment.
What is the difference between pulpitis in children?
Pulpitis of milk teeth in children is a fairly common pathology. Timely treatment of it helps to prevent the development of dangerous complications.
Children's pulpitis is diagnosed several times more often than an adult. Experts explain this phenomenon with the peculiarities of the structure of the teeth of babies. Their connective tissues are characterized by friability, the root canals are wider, and the dentin itself is less mineralized.
It leaves its imprint and imperfection of the immune system. The likelihood of catching a cold in childhood is several times higher than in adult. Nature managed to balance this nuisance by the fact that the disease in 65% of cases is almost asymptomatic. This is the main danger of the disease.
If the baby often complains of toothache, the enamel has become excessively sensitive to hot / cold food, you should visit your dentist. You should not postpone the visit, because the consequences of this disease are unpredictable. Some note that after pulpitis, the tooth hurts even more, while others develop severe swelling and a cyst forms.
The main causes of pathology
The disease usually develops under the influence of negative factors both of a single nature and in the aggregate:
- Exposure to toxins secreted by pathogenic microorganisms in the carious cavity.
- Mechanical damage to the tooth, careless treatment of the oral cavity, nerve damage during surgical procedures.
- Previous acute illness, accompanied by a decrease in immunity.
- Dental treatment with antiseptics with an aggressive formula.
The choice of effective therapy directly depends on the reasons that caused the pulpitis of the tooth in the child. Treatment in most cases allows you to save the molars.
The complexity of therapy for this disease boils down to the fact that the doctor can only eliminate that fragment of the pulp that is located directly in the crown. Its root part is subject to obligatory removal only in fully formed dental roots. This is very difficult in small patients due to the high risk of trauma to soft tissues and the rudiments of permanent incisors.
What are the symptoms of pulpitis?
The clinical picture of pathology is striking in its diversity. There are patients with no complaints and such cases where the symptoms of the disease are clearly manifested (pain discomfort, intoxication of the body, periostitis).
It is very difficult to diagnose pulpitis of milk teeth in children in time, because small patients can not always accurately state their complaints. Therefore, parents often miss the onset of the disease and take the child to the doctor with an acute form.
Among the main symptoms that occur with pulpitis, the following can be noted:
- paroxysmal pains;
- lymphadenitis;
- swelling of the tissues around the tooth;
- general deterioration of the child.
The manifestation of specific signs of the disease depends on its form. Next, we will talk about each pulpitis option in more detail.
Hypertrophic pulpitis of the tooth
What it is? This form of the disease in children is extremely rare. It is characterized by complete destruction of the tooth crown and proliferation of pulp tissue. When probing the affected area, bleeding appears. The child usually does not feel pain. Slight discomfort occurs only during chewing food.
Gangrenous pulpitis
This form of the disease develops against the background of diffuse pulpitis. A small patient practically does not feel discomfort in the oral cavity, but upon examination, there is a darkening of the tooth enamel. An obvious sign of the pathological process is a peculiar bad breath associated with the destruction of the pulp and its interaction with pathogenic microflora. Lymph nodes can be enlarged, but at the same time remain painless.
Exacerbation of chronic pulpitis
An exacerbation of the disease leads to a problematic outflow of exudate and weakened immunity. The child complains of persistent toothache. Lymph nodes as the disease develops, the tissues of the affected area swell. An ailment can be detected only with the help of an x-ray, which usually shows destructive changes in the apex of the root.
Chronic pulpitis
When the body's defenses are weakened, chronic pulpitis of the tooth usually worsens. What is that pathology? Symptoms of the disease are the child's complaints of pulling pain, which intensifies during eating. In addition, the tissues surrounding the tooth become inflamed and swollen, and the lymph nodes increase in size. Sometimes the chronic form is accompanied by an increase in temperature and a deterioration in the general condition of the child.
Acute partial pulpitis
In children with milk teeth, this form of the disease is very rare. Timely detection of the disease is not possible.
Diagnosis of the disease
Modern medicine offers several options for identifying dental diseases. Pulpitis can be found during a dental examination. During the examination, special attention must be paid to the mobility and sensitivity of the teeth. To determine the exact diagnosis, an x-ray is taken and the reaction of the teeth to sensitivity to cold / hot temperatures is checked. Based on the results of the examination, the doctor confirms pulpitis in children of primary teeth. The treatment of the disease is selected individually.
What should be the therapy?
Treatment should be aimed at eliminating inflammation, preventing the development of periodontitis, creating the most favorable conditions for the growth of permanent teeth. In pediatric dentistry, it is imperative that all manipulations are simple and painless at the same time.
How is pulpitis treated? Therapy can be either conservative (biological method) or surgical. The choice of a specific treatment option depends on the neglect of the pathology and its form.
Biological method
This method of treatment is used for chronic fibrous pulpitis of primary teeth. Initially, the doctor opens the inflamed cavity. He places a paste from a mixture of artificial dentin and Shostakovsky balm on its bottom and on the pulp itself. Then the affected area is dried and a phosphate cement filling is placed.
Opinions on the use of a biological method of treatment differ. On the one hand, pulp salvage allows the tops of the roots to fully form in the future. On the other hand, a tooth after treatment for pulpitis often aches and hurts.
Surgical method
The surgical treatment option involves the complete or fragmentary removal of inflamed pulp. There are two ways to manipulate:
- Vital method. During the procedure, the doctor removes the coronal part of the pulp, while the root is preserved. When an infected fragment remains as a result of improper treatment, the likelihood of complications increases (the tooth after the pulpitis may hurt, and the surrounding tissues may swell). Root pulp does not allow pathogenic flora to penetrate into periapical tissues. In order to avoid infection of the wound when opening the cavity, it is necessary to change the burs as often as possible. In the final part, the affected area is washed with an antiseptic solution. The pulp is cut off at the mouth of the canal, and the bleeding is stopped with the usual adrenaline solution.
- The devital method involves the use of arsenic paste, which is applied immediately after removal of the pulp. During manipulations, the doctor, as a rule, uses application anesthesia. Arsenic is left for 1-2 days. Prolonged use of the paste can ruin the periodontium. At the next consultation, the pulp is removed, and a tampon soaked in a special liquid is placed in the cavity. During the third visit, the doctor installs a seal.
The devital method of treatment today is most often used in acute or chronic course of the disease. In the case of gangrenous pulpitis, it is categorically contraindicated.
To summarize
In this article, we talked about why tooth pulpitis develops, what it is and what its primary symptoms are. The treatment of this disease is not an easy task, especially for a pediatrician. The specialist needs not only to eliminate the pathological process, but also to maintain the opportunity for the full development of permanent teeth in the future. Children's dentistry has a number of features and is significantly different from adult.
For those children and their parents who regularly visit the dentist’s office together, it is not difficult to timely detect pulpitis and take the necessary measures for its treatment. If a damaged or discolored tooth is found, the dentist should be visited immediately. Otherwise, the likelihood of developing a complicated infectious process increases.
As a preventive measure, it is recommended to visit the dentist twice a year. Caries detected on time helps prevent pulpitis in children of deciduous teeth. Treatment of this disease is better to begin in the initial stages of development. Be healthy!