Treatment of infant teeth - Causes, symptoms and treatment. MF.
The development of caries in early childhood is promoted by the reduced protective properties of hard tissues, erupting temporary teeth, as well as a decrease in the processes of salivation during the night.
When blossoming caries temporary teeth are affected almost immediately after their eruption. First, on the outer side of the upper incisors, foci of demineralization of the enamel appear, on this background, carious defects appear quickly( within 2-3 months).The carious process is characterized by the rapidity of the flow, as well as the multiplicity of tooth lesions( except for the incisors of the lower jaw) and the rapid involvement of teeth in the pulp process.
In connection with such patterns of caries current problem is its prevention. While mom and dad do not reconsider their views on feeding and the regime of the day, it is impossible to achieve any positive results. It is recommended to remove from the diet of night and night feeding all sugar-containing foods, sour juices.
In addition, it is necessary to observe such a child with a pediatrician, as, as a rule, the emergence of flowering caries is possible as a result of reducing the protective forces of the entire body.
As a local remineralizing treatment for infant teeth, we recommend using calcium-containing preparations at home to treat every day of the child's teeth after each meal with this medication. It is possible to conduct room treatment of teeth with local fluoride-containing products. The multiplicity of such procedures depends on the wishes and possibilities of the parents. The minimum possible multiplicity is 1 time per month.
Most often, with all the recommendations, at this stage, the carious process stabilizes, the initial lesions are remineralized, the development of carious defects is noted, the hard tissues are tightened, separated from healthy tissues. The course of caries acquires a compensated character.
Numerous data show that cariesogenic streptococcal microflora plays a leading role in the development of caries( including in young children), mainly Str.mutans. Infection of the child with a cariogenic microflora is possible both from the mother and other people in contact with him( therefore, caring for the child needs oral sanitation and careful dental care) and from his peers( as evidenced by the genotypic analysis of the microflora of constantly contacting toddlers).Moreover, infection with cariogenic microflora and its colonization( in the grooves of the tongue) are possible even before teething.
For the suppression of cariogenic microflora, mainly two types of drugs are used, belonging to different pharmacological groups - containing antiseptics( chlorhexidine) and sugar substitutes( xylitol).
Specific action of xylitol
The specific antimicrobial effect of xylitol is based on the fact that for cariogenic microorganisms, the absorption of sugars and their enzymatic cleavage is the source of energy for bacterial cells. However, cariogenic microorganisms do not have enzymes that process xylitol, which leads to an overabundance in the cell. As a result, either the death of microorganisms occurs, or the isolation of xylitol back into the oral cavity( with the repetition of the "idle cycle" and the delay in growth and reproduction of the cariogenic microflora).
According to the latest data( Prof. LP Kiselnikova et al., 2009), the use of xylitol-based preparations( ROCS Medical Minerals application adhesive, containing calcium glycerophosphate, magnesium chloride and 10% xylitol) as part of a set of therapeutic and prophylactic measures isthe most effective and physiological in terms of regulation of cariogenic microflora in the oral cavity. A month after the procedures( for children with early caries, 12-36 months), there is a lack of growth of new carious cavities and foci of demineralization, suspension of the development of existing carious defects, disappearance of signs of gingivitis.
Treatment of infant teeth
It is extremely difficult to treat infant teeth in young children, especially if the child already has a negative experience of visiting the dentist. All medical measures at this age should be carried out very quickly and painlessly. As a rule, we do not recommend the use of local anesthesia in children of this age, since a small child may be frightened by the technology itself and the consequences.
Painless treatment of infant teeth is achieved by extensive use of atraumatic methods of carious cavity treatment. The Ukrainian children's dentists have been practicing carcass cavities for temporary teeth for a long time.
Atraumatic methods of treatment are more often used in the treatment of carious cavities localized on smooth and chewing surfaces of teeth. In the treatment of flowering caries, delayed treatment with calcium-containing drugs is commonly used, usually when combined with atraumatic treatment.
In the first visit, partial treatment of carious cavities and application of preparations of the type "Septocalcine"( Septodont), "Life"( Kerr) to the bottom and walls of the carious cavity are carried out, after which the cavity is closed with a temporary seal. After 10-15 days, the final treatment of the carious cavity and sealing is performed.
In the treatment of caries in young children, nevertheless a preference is given to light-curing materials. Chemically curable materials are not recommended for use in children at this age due to the long period of their curing.
Photo 1. Photo 2.
1 - Carious cavities after non-traumatic treatment
2 - Restoration of carious defects
1. 2. 3.
1 -Caris of infant teeth in the child 5 years
2 -Carious cavity prepared for sealing
3 -Conversiondefect
When restorative treatment of temporary molars is widely used technology of preventive filling. In this case, the filling material is located not only in the area of the defect, but also in the region of healthy fissures. To prevent fissure caries erupting temporary molars, it is recommended that they be hermetically sealed.
Complicated forms of caries in early childhood( children under 3 years of age) are often indicative of an oral sanation under general anesthesia.