Pulpitis is a disease of the tissues of the tooth, characterized by an inflammatory nature. It usually develops against the background of improper treatment. This pathology is faced not only by adults, but also by children. From the materials of this article you will learn the causes of the disease, as well as its forms and main methods of treatment.
Tooth pulpitis - what is it?
The pulp is the neurovascular bundle of the tooth. As a result of the penetration of pathogens into this area, an 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 grinding).
Pulpitis is one of the most frequent complaints of patients in dental clinics and at the same time is considered a fairly common disease of milk teeth. In this article, we will dwell in more detail on the manifestations of this disease 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 enoughcommon pathology. Its timely treatment helps prevent the development of dangerous complications.
Children's pulpitis is diagnosed several times more often than an adult. Experts explain this phenomenon by the peculiarities of the structure of the teeth of babies. Their connective tissues are looser, the root canals are wider, and the dentin itself is less mineralized.
Leaves its mark and the imperfection of the immune system. The probability of catching a cold in childhood is several times higher than in an adult. Nature has managed to balance this trouble with 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 overly sensitive to hot / cold food, you should visit the dentist. Do not postpone the visit, because the consequences of this disease are unpredictable. Some note that after pulpitis, the tooth hurts even more, while others have severe swelling and a cyst forms.
Main causes of pathology
The disease usually develops under the influence of negative factors, both single and combined:
- Exposure to toxins released by pathogenic microorganisms in the cavity.
- Mechanical damage to the tooth, careless processing of the oral cavity, nerve damage during surgical procedures.
- A previous acute illness accompanied by a decrease in immunity.
- Treatment of teeth with antiseptics with an aggressive formula.
The choice of effective therapy directly depends on the reasons that caused pulpitis of the tooth in a child. Treatment in most cases saves molars.
The complexity of therapy for this disease comes down to the fact that the doctor can eliminate only that fragment of the pulp that is located directly in the crown. Its root part is subject to mandatory removal only in fully formed dental roots. This is very difficult in small patients due to the high risk of soft tissue trauma and the rudiments of permanent incisors.
What are the symptoms of pulpitis?
The clinical picture of the 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 cannot always accurately state their complaints. Therefore, parents often miss the onset of the disease and bring the child to the doctor already with an acute form.
Among the main symptoms that occur with pulpitis, the following can be noted:
- pain, paroxysmal in nature;
- lymphadenitis;
- swelling of tissues around the tooth;
- general deterioration of the child.
The manifestation of specific signs of the disease depends onits forms. Next, we will talk about each type of pulpitis in more detail.
Hypertrophic pulpitis of the tooth
What is this? This form of the disease in children is extremely rare. It is characterized by the complete destruction of the crown of the tooth and the growth of pulp tissue. When probing the affected area, bleeding appears. The child usually does not feel pain. Minor discomfort occurs only while 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, darkening of the tooth enamel is observed. A clear sign of the pathological process is a peculiar smell from the mouth associated with the destruction of the pulp and its interaction with pathogenic microflora. Lymph nodes may be enlarged, but still painless.
Chronic pulpitis in the acute stage
Problematic outflow of exudate and weakened immunity lead to an exacerbation of the disease. The child complains of constant toothache. As the disease develops, lymph nodes increase, the tissues of the affected area swell. The disease can be detected only with the help of a radiograph, which usually shows destructive changes in the root apex.
Chronic pulpitis
When the body's defenses weaken, chronic pulpitis of the tooth usually worsens. What is it, what kind of pathology? Symptoms of the disease are the child's complaints of pulling pain, which duringmeal time increases. In addition, the tissues surrounding the tooth become inflamed and swollen, the lymph nodes increase in size. Sometimes the chronic form is accompanied by fever and a deterioration in the general condition of the child.
Acute partial pulpitis
In children with baby teeth, this form of the disease is very rare. It is not possible to detect the disease in time.
Diagnosis of disease
Modern medicine offers several options for detecting dental disease. Pulpitis can be detected during a dental examination. During the examination, special attention should be paid to the mobility and sensitivity of the teeth. To determine the exact diagnosis, x-rays are 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 milk teeth. Treatment of the disease is selected on an individual basis.
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 extremely important that all manipulations be simple and painless at the same time.
How is tooth 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 treatment is used for chronicfibrous pulpitis of milk teeth. Initially, the doctor opens the inflamed cavity. On its bottom and the pulp itself, he puts a paste from a mixture of artificial dentin and Shostakovsky's balm. Then the affected area is dried and a phosphate cement filling is placed.
Opinions differ on the use of biological treatment. On the one hand, saving the pulp allows the tops of the roots to fully form in the future. On the other hand, the tooth often aches and hurts after pulpitis treatment.
Surgical method
Surgical treatment option involves the complete or fragmentary removal of the inflamed pulp. Manipulation is possible in two ways:
- Vital method. During the procedure, the doctor removes the coronal part of the pulp, while the root is preserved. When, as a result of improper treatment, the infected fragment remains, the likelihood of complications increases (the tooth after pulpitis can hurt, and the tissues surrounding it can swell). The root pulp does not allow pathogenic flora to penetrate into the periapical tissues. To avoid infection of the wound when opening the cavity, it is necessary to change burs as often as possible. At the final part, the affected area is washed with an antiseptic solution. At the mouth of the canal, the pulp is cut off, and the bleeding is stopped with the usual solution of adrenaline.
- The devital method involves the use of arsenic paste, which is applied immediately after pulp removal. During manipulations, the doctor, as a rule, uses topical anesthesia. Arsenic is left for 1-2 days. Long-term use of the pastecan destroy the periodontium. At the next consultation, the pulp is removed, and a swab soaked in a special liquid is placed in the cavity. During the third visit, the doctor places a filling.
The devital method of treatment today is used most often in acute or chronic course of the disease. In the case of gangrenous pulpitis, it is categorically contraindicated.
Summarize
In this article, we talked about why tooth pulpitis develops, what it is and what are its primary symptoms. 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 preserve the opportunity for the full development of permanent teeth in the future. Pediatric dentistry has a number of features and differs significantly from adult dentistry.
For those children and their parents who regularly visit the dentist's office together, it is not difficult to detect pulpitis in a timely manner and take the necessary measures for its treatment. If a damaged or discolored tooth is detected, a visit to the dentist should be made without delay. 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 in time helps to prevent pulpitis in children of milk teeth. Treatment of this disease is best started at the initial stages of development. Stay he althy!
