Profound and long standing untreated decays in children’s teeth can progress deep into the root canals of baby teeth and thereby lead to infections or abscess.
The most common treatment suggested for such teeth is to extract and place a space maintainer.
With the contemporary approach of Erbium and Diode lasers in Pediatric Dentistry, Root canal treatments of teeth with infections can be successfully performed.
On scientific grounds, its proven that bacteria reside in root canals up to the depth of 1000 um. Lasers can sterilize the root canal chambers up to the depth of 600 um to 800 um which is significantly higher than 1000 um with the conventional treatments.
Lasers can reach the tight spots ( side branching of the canals, bifurcations etc.) in the canals which are otherwise not accessible with conventional irrigation solutions.
Abscess or swellings in the periapical or root region in the primary teeth are complex in terms of bacterial presence. There are wide variety of bacteria that can inhabit these regions. Due to the complex bacterial presence, two types of lasers are used in the treatment.
Erbium group of lasers help in gaining access of the cavity, and remove smear layer which may otherwise block the tubules and thereby block the access to those bacteria that may hide there.
Erbium lasers are also used in the root canals along with the irrigation solutions. This allows deeper access of the irrigation solutions and further sterilisation.
Diode lasers are used as the last step just before the filling of the root canals.
Usage of Dual wavelength lasers in the root canal system, hence, allow higher success rate with root canal treatments. Sometimes, this treatment can be completed in two or three appointments based on the severity of the abscess or swelling.
Some of these bacterial colonials may be resistant to any form of treatment. In such cases, there is a possibility that treatment can fail and thereby tooth may need extraction as the final resolute.
One of the most important factor in Pediatric Dentistry is that any treatment for baby teeth only requires a certain period of success until the new permanent tooth takes over. If in any case, root canal approach with lasers does not seem to suffice with infection, tooth can be planned for extraction keeping in mind that the time gained under immediate treatments is still a success as baby tooth is each day close to the time of exfoliation.
