The type of treatment selected to restore a tooth depends on a few factors: where the decayed tooth is located, how severe the decay is, and whether it is a primary tooth or a permanent tooth. With this information, our dentists will make the best recommendation for your child’s treatment. The following explains some of the most common procedures we perform at TLC.
A filling can repair a damaged tooth and help prevent further decay by sealing off any cracks where bacteria can enter. If your child has a tooth that requires a filling, our dentists will first remove the decayed portion of the tooth, clean the area, and fill it with a filling material. Our office utilizes resin filling material.
Composite resins are custom made to match the natural color of your teeth, and usually last between 3 to 10 years. Although it works well, resin material is not as strong as the original tooth. For that reason, if your child has a large decay or a fractured front tooth, a resin crown may be recommended instead. It is important to note that certain foods, drinks, and tobacco can stain resins.
A crown, also known as a “cap”, is used to cover a damaged tooth. When a child’s tooth is damaged due to decay or trauma, and more than one surface of the tooth is affected, our dentists may suggest the placement of a crown over the tooth. A crown is more durable than a filling, and normally last until the child’s permanent teeth erupt. A cap can be used under various circumstances including:
- Protect a tooth from fracturing
- Restore a fractured tooth
- Cover a discolored or poorly shaped tooth
- Cover a tooth that has had pulp therapy
- Replace a large filling when there is little tooth structure remaining
The “pulp” is found at the center of each tooth, and is composed of nerves, tissue, blood vessels, and reparative cells. It cannot be seen with the naked eye. There are various ways in which a pulp can be damaged including tooth decay or a traumatic injury. Pediatric dentists perform pulp therapy (also known as nerve treatment, children’s root canal, pulpectomy or pulpotomy) in order to restore and save the affected tooth. After performing an examination and reviewing x-rays of the affected area, the pediatric dentist will assess the child’s condition and determine whether he/she will need a pulpotomy or a pulpectomy.
- A pulpotomy is performed when the affected area is solely in the crown portion of the tooth (pulp root remains unaffected). The pediatric dentist will remove the affected pulp and the surrounding tooth decay, and place within the gap an agent that prevents infection and calms the nerve tissue. The pulpotomy is usually completed with a stainless steel crown to protect the tooth and minimize the risk of future fractures.
- A pulpectomy is performed when both the crown and the root of the tooth has been severely injured or decayed. During this treatment, the pediatric dentist will remove the pulp, cleanse the root canals, and fill the area with reabsorbable material (non-reabsorbable material is used in permanent teeth). The final step is to place a crown on the tooth (stainless steel or a natural-colored covering) in order to add extra support, protection and strength.
Primary teeth play an important role in a child’s life as they assist in pronunciation, proper chewing, and the eruption of permanent teeth (by holding the necessary space). For this reason, our dentists do their very best to preserve these teeth when providing treatment. However, there are still some circumstances when a tooth may need to be extracted. Tooth extractions may be necessary in the following situations:
- The tooth cannot be saved (severe decay)
- The tooth is infected or has abscess
- The primary tooth fails to fall out and prevents the permanent tooth from erupting
- The teeth are crowded
- Orthodontic treatment requires the tooth to be extracted
- Impacted wisdom teeth
When a primary tooth is lost early, the neighboring teeth may slide into that space interfering with the eruption of the permanent tooth. A space maintainer prevents this from happening. A space maintainer is custom made for your child, and will be monitored by our dentists until the permanent tooth erupts, at which time the spacer will be removed.