Pulpotomies & Stainless Steel Crowns
If your child has been complaining of discomfort due to a cavity, you know that it must be seen by a dental professional. A dental professional can evaluate the degree to which the tooth is decayed and whether or not filling the cavity with a traditional filling material will be enough to remedy the concern.
In cases where pediatric dental decay has progressed into the pulp of the tooth, your dentist will rely on a combination of visual observation and digital imaging to determine whether a pulpotomy is required. Since digital x-rays only show hard tissues, it can be difficult to determine degree to which the pulp of the tooth is impacted by the decay until the tooth has been opened for observation. Since the dental pulp is located closer to the surface of the tooth in children, it is not uncommon for decay to infect the pulp of the tooth, requiring a pulpotomy.
What is a Pulpotomy?
A pulpotomy can be thought of as a form of root canal in which only the portion of the pulp contained in the crown of the tooth is removed, and the tissues in the root canals themselves can be preserved. Like root canals, pulpotomies require local anesthetic and the possibility of oral sedation in order to maintain your child’s comfort throughout the procedure. Your dentist will first apply a numbing agent to the gum tissue around the affected tooth and once the soft tissue is sufficiently numb, a local anesthetic can be administered using a syringe. If your child is showing signs of substantial anxiety, an oral sedative can be safely provided to your child to assist them and remaining calm and relaxed throughout this procedure.
Once your child is relaxed and their tooth has been effectively numbed, the dentist will begin by opening the crown of the tooth to expose the pulp. Once the affected pulp has been removed from the crown, your dentist will have a clear line of sight into the tooth in order to effectively determine whether or not a pulpotomy will suffice. Where pulpotomy is appropriate, the infected tissue of the upper tooth is removed and a medicated agent is applied inside of the tooth to ensure that the infected portions of the tooth remain clean and ensures the prevention of further infection.
Stainless Steel Crowns
In pediatric pulpotomies, the procedure is typically followed by the installation of a stainless-steel crown. Stainless-steel crowns serve to seal the entire crown of the child’s tooth in order to preserve the tooth and ensure resistance to further decay. The decision to use stainless-steel crowns or not considers multiple factors such as the type and area of the tooth, the number and severity of cavities, the ability of the patient to be compliant to a regular standard of oral hygiene as well as the aesthetic.
Your dentist will file down the natural tooth which is a process known as etching, and once the tooth is prepared, a mold can be made of the new tooth shape. The crown can then be ordered for placement in the mouth at a later date, and a temporary crown is placed for the time being.
Stainless-steel crowns are very durable for the pediatric mouth. They are also cost-effective, which is appreciated when baby teeth are concerned since they will be lost in the next few years. Stainless-steel crowns are made of a combination of iron, carbon, chromium and other metals, so they may not be appropriate where metal allergies are present.
Caring For Stainless Steel Crowns
Your child’s new stainless-steel crown is very resistant to the effects of plaque bacteria and decay in the oral cavity. This does not mean, however, that regular oral care is not still required. The tissues surrounding a stainless-steel cap, including the gums and the root system, are susceptible to the effects of plaque bacteria and acidity within the mouth. If these bacteria are not actively controlled, they can lead to gingivitis, periodontitis and other health concerns. Assist or monitor your child as they brush their teeth twice a day and floss between each set of teeth that are touching a minimum of once-daily. When your child loses their baby tooth with the stainless-steel cap, their natural adult teeth can emerge from the gums successfully thanks to a pulpotomy and stainless-steel cap that successfully allowed the tooth to remain in the mouth.
Why is a Pulpotomy & Stainless Steel Crown Preferable to Extraction?
Since baby teeth serve as placeholders to guide and direct adult teeth as they emerge, they are an important part of your child’s growth and development. Removing a tooth is possible when damage to the tooth has been too severe to safely salvage, however, a space maintaining appliance may be required to ensure that appropriate spacing is maintained in the mouth to allow adult teeth to emerge easily.
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