What is Pulp Therapy?!

The pulp of a tooth is the inner, central core of the tooth. The pulp contains nerves, blood vessels, connective tissue and reparative cells. The purpose of pulp therapy in Pediatric Dentistry is to maintain the vitality of the affected tooth (so the tooth is not lost).

Dental caries (cavities) and traumatic injury are the main reasons for a tooth to require pulp therapy. Pulp therapy is often referred to as a "nerve treatment", "children's root canal", "pulpectomy" or "pulpotomy". The two common forms of pulp therapy in children's teeth are the pulpotomy and pulpectomy.

A pulpotomy removes the diseased pulp tissue within the crown portion of the tooth. Next, an agent is placed to prevent bacterial growth and to calm the remaining nerve tissue. This is followed by a final restoration (usually a stainless steel crown).

A pulpectomy is required when the entire pulp is involved (into the root canal(s) of the tooth). During this treatment, the diseased pulp tissue is completely removed from both the crown and root. The canals are cleansed, disinfected and, in the case of primary teeth, filled with a resorbable material. Then, a final restoration is placed. A permanent tooth would be filled with a non-resorbing material.

Two Rows of Teeth!

If your child has a tooth growing in behind another tooth, don’t panic! We like to call those, "Shark teeth!" It’s a relatively common occurrence in children, and although it can look scary, it’s easy to treat and there are not usually ongoing problems.

Most children will start to lose their baby teeth and get permanent teeth between the ages of five and seven. When a permanent tooth erupts directly underneath a baby tooth, it resorbs the root of the baby tooth, causing it to become loose and fall out so that the permanent tooth can take its place. Sometimes, however, a permanent tooth will not grow in directly underneath the baby tooth, and the root of the baby tooth will remain intact and it will not get “pushed out”. When that occurs, the permanent tooth will usually start to come in right behind the baby tooth, giving a child a “shark tooth” appearance. The most common place for this to occur is the lower and upper front teeth, but it can happen anywhere.If your child has a tooth behind a tooth, you need to check how loose the baby tooth is. If it’s very loose, encourage your child to work on wiggling the tooth out. If he or she can get it out on their own, that’s always best. If the tooth is only a little bit loose or not loose at all, he or she may have to come to our office to get the tooth extracted.Once the baby tooth is out, your child’s tongue will naturally push the permanent tooth forward into the correct position. Children who have moderate to severe crowding may not have room for the permanent tooth even after the baby tooth is out, and an orthodontic consultation would be appropriate.

If you’d like to call our office to discuss your child’s situation, we would be happy to help you decide what the best course of action is.
303-627-8300

First Visit - Checklist
 

Have a little one at home?!
Make sure establishing a Dental Home is on your list of to-do’s, especially if your child has already had their first birthday.

Because baby teeth are the blueprint for permanent teeth, caring for them is important. While tooth decay can impact children’s ability to eat and sleep, it can also impact a child’s ability to learn at school and speak clearly. Remember to schedule a visit with a pediatric dentist to ensure healthy little teeth and keep this checklist handy for an enjoyable first visit and as a refresher for check-ups.

• Schedule your first pediatric dental visit to establish a Dental Home, or “home base,” for your child’s dental needs by your child’s first birthday. Remember, it’s never too late!
• If you have a toddler who hasn’t seen a pediatric dentist before, consider a “get acquainted” visit so your child can get familiar with the dental office before the first appointment.
• Answer all your child’s questions positively and be careful about using scary words. Check-ups and 90 percent of first visits do not have anything to do with “hurt,” so don’t even say the word!
• Read your child a story about a character who had a good dental visit. 
• Give your child some control over the dental visit. Such choices as “Will you hold your bear or should I?” or “Which color toothbrush do you like?” will make the visit more enjoyable.
• Give center stage to the pediatric dentist and allow him and his team to do most of the talking to build a better relationship with your child. Remember, you will be able to discuss with the pediatric dentist after the examination.

Lip Biting After Treatment

Some dental procedures use anesthetic to reduce pain for your child. As the anesthetic wears off, typically over 2-3 hours, your child will notice a tingling sensation in the mouth, tongue and/or cheek areas. Monitor your child during this time to ensure that he or she does not bite, chew, or scratch at these numbed areas.

Avoid feeding your child solid food until the numbness has subsided. Good choices include soft snacks such as Jell-o, frozen yogurt, milkshakes and/or smoothies. It is best to spoon these snacks instead of using a straw. Also, avoid acidic food and drinks including tomato based foods, sauces, and citric juices while there is an open wound.

If your child bites his or her cheek, tongue or lip, there may be swelling which can worsen for up to five days. This is typically seen in a child under the age of 8. A soft scab may form that looks like a yellowish white plaque or a large traumatic ulcer. This is a normal part of the healing process and this lesion should heal during the next 10-14 days.

Clean the area well, brush teeth as normal, and be gentle around the affected area. You may give your child children’s acetaminophen (Tylenol^®) or ibuprofen (Motrin^®) for pain and apply Orabase over the swollen areas.

Overall, try to watch your kiddos closely for the few hours following treatment to avoid any complications or lip/cheek biting,

Why Does My Child Need a Space Maintainer?

Your child’s primary teeth (baby teeth) play an important role in their dental health. Not only do they save space for the permanent teeth but they also help guide them into position and encourage normal development of the jaw bones and muscles.

A baby tooth usually stays in place until the permanent tooth underneath pushes it out and takes its place. If your child looses a baby tooth too early, the adjacent teeth are more likely to tilt or drift into the empty space and create limited space in the jaw for the permanent tooth to erupt. If left untreated, the permanent tooth can come in crowded or be blocked from erupting.

A space maintainer works by keeping open the empty space left by the lost tooth. Usually made of metal, this temporary, custom-fitted appliance steadies the remaining teeth and prevents movement until the permanent tooth takes its natural position in the jaw.

Space maintainers are more affordable and easier on your child to keep teeth in normal positions than to move them back into place with orthodontic treatment.