Modern Management of caries as per risk assessment:
Dental caries, or tooth decay, is one of the most prevalent diseases in humans, affecting 97% of the population worldwide during their lifetimes.
The term “dental caries” can be used to describe both the disease process which causes cavities and the lesion/cavities(non-cavitated/white spots or cavitated/holes) that are formed as a result of the disease process.
The most contemporary trend in treating dental caries is using nondestructive/minimally invasive risk-based caries management strategies rather than focusing on restorative treatment alone.
Caries risk assessment is a valuable tool that categorizes a child’s overall risk of developing caries disease and helps plan the prevention and management of dental caries.
Evaluation of the same for a child based on their history, home hygiene, and clinical examination would allow for a personalized treatment/prevention plan for the child.
Read a recent review from one of the parents for the treatment of dental cavities.
Dental restorations/cavity fillings:
Any breakdown or hole in a primary or permanent tooth leads to more food accumulation and cavities progressing rapidly. Parents really don’t have to wait until the child complains of pain. Pain is usually an advanced stage of decay and cavities.
A dental restoration or dental filling is a treatment to restore the function, integrity, and form of missing tooth structure resulting from caries or any injury. In today’s time, restorations (done) are way advanced and as natural as tooth. Glass Ionomer filling (GIC) is ideal for the pre-cooperative or uncooperative child as well as the “high caries risk” child. Glass ionomers have many advantages as a restorative material.
These include, but are not limited to, the ability to bond chemically to dentin and enamel, biocompatibility, and act as a fluoride release and then as a reservoir. We are proud to use the best GIC fillings of the world for our children. Likewise, we also have composite tooth-colored restorations that offer a strong and esthetic alternative and are done in ideal clinical situations.
Does my child really need a crown? Isn’t he too young for it? Don’t we need a crown only after RCT/nerve treatment? These are the most frequent question in parents’ minds. We need to realize that a crown or a cap is nothing more than a sturdy all-surface restoration/filling when the conventional one won’t suffice.
A crown is a restoration that covers a tooth to strengthen it and restore it to its normal shape and size. A crown may be placed to support a large filling when there is little remaining tooth structure and teeth that have undergone nerve treatment to provide strength and support to the tooth.
Crowns protect the teeth from further damage and restore the tooth to an ideal contour and position in the mouth. The primary tooth with a crown will be shed normally at the appropriate time, and one doesn’t have to worry about getting it removed separately.
At Tooth Tales, we have both sturdy stainless steel and advanced tooth-colored zirconia crowns for both front and back teeth. In high caries-risk children, definitive treatment of primary teeth with crowns is better over time than multi-surface intra-coronal restorations. One can discuss the choice with the doctor during treatment planning.
My Child Lost a Filling/Crown
Save the crown if possible, as we might be able to reuse it. Have your child gargle with salt water to clean the area and brush the tooth gently. Discourage them from chewing with the exposed tooth. Use dental floss to remove food particles that may cause painful swellings of the gums.
Nerve treatment/Pulpal therapy/RCT in primary teeth:
Yes, it is done day in and day out for children all over the world for all the reasons. We would be happy to bust that age-old myth of most of the parents.
And the best part is you really don’t have to get scared for it or compare it with your own past experiences. It is nothing more than a pediatric dental treatment used to treat and preserve a child’s natural tooth that has been affected by an injury or tooth decay.
The nerves/dental pulp is soft tissue located deep inside the teeth, which is like a heart for the same. When a tooth becomes damaged or decayed, the pulp may be exposed to bacteria, causing infection and pain.
Rather than extract the tooth entirely, the infected pulp may be removed and replaced with a suitable biomaterial that prevents bacteria from further damaging the tooth. The ultimate objective of these procedures is to save the tooth so that it will maintain the integrity and function of the dental arch.
At Tooth Tales, we do this quite regularly with much ease and comfort of your child, mostly in a single visit. But yes, we would be happier if you come to us before you need these invasive treatments for your child.
Minimally Invasive Pediatric Dentistry
As the field of dentistry advances and the use of technology in the field increases, the concept of minimally invasive dentistry has emerged. Preservation of a healthy set of natural teeth for each patient should be the objective of every dentist. The following core beliefs characterize minimally invasive dentistry:
- Regard original tissue as more valuable than its artificial counterpart.
- Preserve, rather than replace, original tissue.
- Focus on the prevention of disease above its treatment.
- When treatment is necessary, use invasive means as little as possible.
- Focus on remineralization of enamel and dentin as a preventive effort in treating caries.
Resin infiltration is a minimally invasive restorative treatment for those white spots lesions (WSL) due to early caries or some developmental conditions like Molar incisor hypomineralization.
It seems to provide an intermediary treatment modality between prevention and restorative therapy. The concept was introduced as a micro-invasive approach for the management of these spots without any drilling or anesthesia at all.
Unlike whitening products, Icon resin infiltration is considering to be a long-term treatment solution. Research shows stability for at least two years. At Tooth Tales, we offer this contemporary treatment to help fade the appearance of WSLs & hypo spots, and in most cases, it provides a significant cosmetic improvement in one simple, painless visit.
Silver Diamine Fluoride-A new cavity fighting liquid !
We all used to wonder and hope for a “wonder drug,” which takes care of all little children’s cavities. Well, we have something closer to that now, which would certainly be an excellent option for some who are hoping to avoid the dentist’s drill!
Silver Diamine Fluoride is an antimicrobial liquid that can be applied with a small brush to cavities on primary and permanent teeth to stop their progression and to remineralize teeth without having to cut into them.
This is especially helpful in small children who are not mature enough to handle routine restorative care. This liquid takes less than 1 minute to apply with no noise, no drilling, and at the same time, it kills the bacteria immediately that caused the decay.
Sometimes SDF and a minimally invasive filling can be a great option for conservative treatment without local anesthesia. At other times, SDF can be used to delay treatment until a child is older and better able to tolerate definitive treatment.
On larger cavities, it can be followed with traditional fillings or crowns to regain the anatomy and function of the teeth. It is important to note that SDF cannot be used on symptomatic teeth (e.g., causing pain, are infected) and that SDF-treated sites will turn grayish-black (only the cavity and not the whole tooth).
Not all children are candidates for treatment with SDF. It can be a great tool for young children (under age three) and those with special needs when it is necessary to delay sedation or hospital dentistry.
Although no child, parent, or doctor hope or is willing for it, but in certain cases and situations, tooth removal may be necessary for a variety of reasons— including trauma, dental infections/abscess, loose baby teeth, over-retained teeth (permanent teeth erupting without baby teeth falling out),
supernumerary teeth (“extra teeth”), request from an orthodontist, etc. Over the years, we have mastered this art of removal with as pleasantness as possible. Preparing the child for the same, along with laughing gas, audio-visual distraction, and good communication, really help in the alleviation of fear and anxiety.
We also employ advanced cartridges and a hemostatic sponge for profound numbing and quick recovery of the child. Healing usually happens uneventfully within 7-10 days.