ROOT CANAL TREATMENT IN PEDIATRIC DENTISTRY

Dr. Swapnil Rachha (Consultant Pedodontist), Mumbai

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  • Root Canal Treatment (RCT) is also called as endodontic treatment of a tooth.
  • Tooth has 2 outer layers which are hard, called as Enamel and Dentin.
  • These 2 layers cover an inner most part of a tooth called as PULP.
  • PULP is a soft tissue which is made up of nerves and vessels.
  • Whenever a dental decay affects Enamel and Dentin reaching the PULP chamber one gets pain due to infection and inflammation.
WHEN IS THE ROOT CANAL TREATMENT IS REQUIRED?

RCT is required in the following conditions-

  • Deep decay involving the Pulp chamber.
  • Traumatic/ injured tooth.
  • Sensitive tooth due to severe erosion and attrition.
  • Tooth with a crack on it.
  • Intentional RCT in some cases of crown and bridge.
WHAT DO WE FEEL ?
  • Food lodgment in decayed tooth.
  • Tooth ache which worsens at night.
  • Swelling associated with painful tooth.
  • Pus discharge.
  • Fever.
WHAT IS RCT?

Although medicines are prescribed sometimes, they will give a temporary relief from pain.

  • RCT method varies in children and adults.
  • It usually requires 2-3 sessions.
  • At first Xray is made to evaluate decay and infection of the tooth.

Steps of RCT in Children (milk teeth):-

  • Anesthesia is injected so that the treatment becomes almost painless.
  • All the decay is removed.
  • Tooth is cleaned and shaped till the end of the roots.
  • Cleaned and disinfected roots are filled with medicinal paste which will not affect the natural exfoliation process of the milk tooth. And crown portion of the tooth is filled with a restorative material.
  • Then preformed Stainless Steel crown or Zirconia Ceramic crown is placed over the tooth.

Steps of RCT in ADULTS (permanent teeth):-

  • First 3 steps of RCT are same as RCT done in children (milk teeth).
  • Cleaned and disinfected roots are filled with inert material called as Gutta Percha.
  • Crown portion of the tooth is filled with restorative material.
  • Then the crown is placed over the tooth (metal, metal-ceramic or full ceramic crown)
WHY CROWN AFTER RCT?
  • Crown gives additional strength and support to the tooth which it has lost due to decay.
  • Improves mastication.
  • Increases longevity of tooth.
  • Decreases chances of reinfection.
POST RCT CARE
  • One should not eat anything hard from the RC treated tooth, until it is secured with a crown.

Fig 1

RCT if done in right time can save a tooth from removal

PREVENTION

AT HOME:-

  1. Brushing twice a day with fluoridated tooth paste.
  2. Floss in between the teeth to prevent food lodgement.
  3. Use of a mouthwash as advised by a dentist.

AT DENTAL CLINIC:-

  1. 6 monthly check up.
  2. Preventive treatment- sealants.
  3. Scaling and polishing.
  4. Fluoride application.

However, if possible saving the natural tooth is best because nothing can function as efficiently as a NATURAL TOOTH.

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