Frequent consumption of sugars from panela, chocolate, cookies, gums, cakes, soft drinks, artificial juices in bottles or boxes, and snacks, added to insufficient or inappropriate oral hygiene practices are directly related to dental caries. These habits favor the accumulation of dental plaque on the teeth and cause dental caries lesions to develop over time.
On the other hand, there are special groups that tend to more easily develop dental caries lesions, such as babies between 12 and 30 months (known as bottle caries, rampant caries, or early childhood caries); children between 6-7 years of age (time in which the first permanent molar or the 6-year-old tooth appears); patients with orthodontics or fixed or removable orthopedic appliances; patients suffering from “dry mouth” associated with medications, diseases or head and neck root; patients with special needs and patients with motor difficulties. Tooth decay not only affects tooth enamel, but also dentin, cementum, and consequently, the root of the teeth.
What Are The Symptoms Of Tooth Decay?
Tooth decay lesions are the reflection of dental caries disease, and the first clinical sign on the teeth are white, opaque, and rough spots that develop on the surfaces of the teeth where antibacterial plaque accumulates more easily, that is, on the molars, between one tooth and another, or on the front of the teeth near the gum. This type of injury is generally painless but requires control by the pediatric dentist. When these types of lesions advance, they can affect the enamel and dentin and cause pain caused by consuming food or drinks, and in more severe cases, it can affect the tooth’s nerve and cause spontaneous pain.
What About The Use Of Fluoride Toothpaste In Children?
Fluoride has proven to be a highly effective agent for the control of dental caries and its cariostatic effect is topical, that is, in contact with the tooth / bacterial plaque. Different dental associations in the world, such as the European Academy of Pediatric Dentistry, the American Academy of Pediatric Dentistry, and the Latin American Association of Pediatric Dentistry recommend the use of fluoride toothpaste with at least 1,000 ppm of fluoride (this information is available at the back of toothpaste and is expressed as ppm F). Babies with at least one tooth and up to two years are recommended to use 1,000 ppm F toothpaste twice a day, equivalent to a grain of raw rice. Children between the ages of 2 and 6 can use toothpaste with at least 1, 000 ppm F twice a day equivalent to a pea (the concentration can be increased depending on the individual risk, determined by the pediatric dentist). Children over 6 years old should use 1,450 ppm F toothpaste twice a day.
Tooth decay is a common and communicable infectious disease caused by bacteria that affect teeth.
These bacteria adhere to tooth enamel (the outermost surface of the tooth) and metabolize dietary sugars, producing acids, which demineralize and weaken the tooth over time.
The Consequences Of Tooth Decay In Children Include:
- A higher chance of cavities in the permanent dentition
- Pain
- Difficulty eating
- Facial swelling
- Emergency visits
- A more expensive treatment
When the tooth becomes painful, there are usually two options. The first option is to extract the tooth that is causing the pain, and the second option would be to do a root canal. Many people have a misconception of the fact that you only need a root canal if your tooth hurts, however, this is not true. It is true for most people that if there is a lot of decay in the tooth, it becomes symptomatic, however, for some, it remains asymptomatic without causing pain until the tooth is severely rotten to the point where the tooth becomes unrecoverable.
A root canal is a final resource in saving your tooth. If the tooth has too much cavity to start with, as it would be impossible to accumulate even after a crown procedure, root canal therapy would not be indicated. The general idea would be that if you don’t have too large a cavity you can get fillings and if the cavity gets closer to your pulp chamber you would need a root canal to recover the tooth. However, if the cavity is too large, it may even be too late for a root canal and the tooth needs to be removed.
Each tooth has dental pulp (pulp chamber) within the tooth, which is a center of the tooth that contains nerves, blood vessels, and connective tissues. Within each root, there is a root canal, in some cases more than one root canal, which contains nerves. By doing root canal therapy (endodontic therapy), we are removing the nerve and making the tooth asymptomatic.
Signs That You Need A Root Canal:
- Toothache
- An abscess (ball in the gum tissue)
- Discoloration (due to injury)
- Too much sensitivity in a specific tooth, especially after a large filling
- X-ray showing the presence of a cavity near the nerve causing perforation in the pulp chamber
The Root Canal Procedure
Root canal therapy may require one or two visits to complete the entire procedure. Depending on the level of infection, your dentist may prescribe antibiotics before starting the procedure, as anesthesia may not work very well with the infection. The infection usually compensates for the anesthesia. On the first visit, the pulp chamber is accessed by drilling a small hole in the upper surface of the tooth. The nerve canals in each root are then removed. On the second visit, the nerve canals and root canal fillings were emptied. Depending on the case, these two visits can be combined into one visit. In general, incisors (front teeth) and premolars are much simpler compared to molars and may require only one visit.
How Is Root Canal Therapy Performed?
If you suffer from any of these symptoms, your dentist will likely recommend non-surgical treatment to remove the diseased pulp. This therapy usually involves local anesthesia and can be completed in one or more visits depending on the treatment required. The success of this type of treatment occurs in approximately 90% of cases. If your tooth is not amenable to endodontic treatment or the probability of success is not favorable, you will be informed at the time of consultation or when a complication becomes apparent during or after treatment. We use local anesthesia to eliminate discomfort. Additionally, we will provide nitrous oxide analgesia if indicated.
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