Pediatric Dentist

Different Dental Problems

1. Neonatal teeth

This condition is seen in newborn babies, there is an eruption of teeth by birth. This erupted tooth causes difficulty to the child during breastfeeding and also hurts the feeding mother.
Treatment:-
With proper precautions, this small neonatal tooth is removed by giving small local anesthesia.

2. Nursing bottle caries:-

This condition is typical with kids who sleep by keeping nursing/feeding bottles inside their mouths. The milk is usually mixed with sugar. This sugar along with milk gets deposited on the tooth surface, particularly on the maxillary ( upper ) front teeth and mandibular ( lower ) front teeth. This deposition causes the secretion of acids and leads to decay. As deciduous teeth are very thin, they get damaged in no time. ( Pic 1:- typical case of nursing bottle caries ) Consult a dentist if there is decay in the front teeth. Discoloration of front teeth. If the child is complaining about small swelling on the gums. These are some of the signs parents should see and immediately consult a dentist. If not treated, it may lead to early loss of teeth. And further complications in permanent dentition. 
Treatment:-
Immediately stop the habit of sleeping with a bottle in your mouth. This habit causes many problems in the future and should be stopped immediately. Complete removal of decayed part of teeth followed by either endodontic treatment and crowns or composite restoration as dentist/ pedodontist suggests.

3. Decayed teeth:-

The size of deciduous teeth is very small. The thickness of enamel and dentine is a few millimeters only. A small cavity in enamel aggressively expands into dentin. Early detection always helps to avoid further complications. Small discoloration or decay, if treated well in advance can avoid further root canal treatment and crowns.
Treatment:-
The dentist examines all teeth and small pinpoint caries are detected. Complete Decay is removed with a small bur. And either glass ionomer cement or composite restoration is done. It’s a painless process and takes a few minutes.

4. Pain and sensitivity:-

If small decay is not treated in time, penetrates dentine and involves pulp tissue. Pulp tissue contains blood vessels and nerves. Once decay along with pathogens reaches pulp tissue, the child complains of pain. Pain could be mild while eating, eating sweets, hot and cold. If not treated at this stage, the pain aggravates and there is continuous throbbing pain. Child, I am not able to sleep. This condition is called “pulpitis”.
Treatment:-

Examination of teeth helps to diagnose the cause of pain. The intraoral radiograph reveals decay has reached the pulp. The treatment is pulpectomy. I.e complete removal of infected pulp from pulp chamber followed by cleaning and shaping of canals and filling it with special cement. This procedure is similar to root canal treatment of permanent teeth. But canals are filled with different materials.

It is followed by a crown to protect the tooth. This treatment is done under local anesthesia and is usually done in a single visit. 

5. Gum boils:-

Small swelling of gums around the decayed tooth is called gum boil. The child complains of small swelling around the tooth and pus discharge. This condition is usually asymptomatic and regresses on its own. When a decayed tooth is not treated in time, pathogens reach the apex of the root causing periapical inflammation and accumulation of infection in bone surrounding roots. This infection follows the path of least resistance and reaches gums and forms gum boils. This boil rupture and drainage of infection. If left untreated, leads to loss of bone and may damage the permanent dentition in the future.

Treatment:-
pulpectomy is the treatment for gum boils. As mentioned earlier, complete removal of infected pulp tissue along with infection is done. Followed by irrigation and cleaning of debris. And filled with biocompatible cement. After treatment of the root canal, gum swelling disappears immediately.

6. Extraction of teeth:-

removal of deciduous teeth. This procedure is done under local anesthesia. child dentist

Extraction of decayed tooth:- Due to negligence, the deciduous teeth get grossly decayed and in such a situation, they need to be removed to avoid further damage to permanent dentition. 

Serial extraction of teeth:- To guide permanent teeth to erupt in alignment, sometimes we need to remove deciduous teeth intentionally. It is known as serial extraction of deciduous teeth. This intentional removal of teeth helps to avoid crowding and malalignment of permanent dentition.

Extraction of over-retained teeth:- Sometimes, some parts deciduous teeth remain in the mouth even after the eruption of permanent teeth. These over-retained deciduous teeth need to be extracted. This treatment is usually done under local anesthesia.

7. Space maintainers:-

Deciduous teeth not only help in mastication, aesthetics & phonetics, but they also work as a natural space maintainer. They maintain the space required for permanent teeth. If a deciduous tooth is extracted, there is a need to maintain space. In such situations, space maintainers are given.

Treatment:-
Two types of space maintainers
1. Removable space maintainers
2. Fixed space maintainers

Removable space maintainers

There are different removable space maintainers like acrylic partial dentures, full or complete dentures, and removable distal shoe maintainers. These are not preferred because they are completely dependent on the kid. If a kid doesn’t wear on time, they are of no use.

Fixed removable space maintainers are of the following types

• Distal shoe
• Lingual arch
• Palatal arch
• Band and bar type
• Band and loop space maintainer
• Crown and loop appliance
• Aesthetic anterior space maintainer