It is quite often that we come across situations where young children get cavities that are deep seated leading to infection in the third layer i.e. nerve or pulp of the tooth.
In these scenarios, child may complain of pain, discomfort and swelling in the gums.
On clinical evaluation, it may appear as swelling or sometimes as abscess.
Radiographic or Xray evaluation shows dark areas in between the roots of the tooth or dark area at the tip of the root, close to the developing crown of the underlying permanent tooth.
The most common form of treatment that’s followed is removal of the baby tooth followed by fixed spacers. With multitude of advancement in diagnostics and treatment planning, this modality can be replaced with lasers assisted root canal approach.
The current, holistic and more functional form of the treatment is to perform laser assisted root canal treatment in baby tooth that allows it to last in the mouth until its natural time of exfoliation.
Laser assisted root canals in children are performed without any local anesthesia in the gums. If the child is sensitive to procedure, the same can be done under Nitrous Oxide Conscious sedation. Both Erbium and Diode lasers are used for different purposes. Erbium lasers help to get the access into the root canal. Both Diode and Erbium lasers are then used after the conventional steps of root canal treatment in order to achieve appropriate sterilization.
Based on the extent of infection, root canal treatment can be completed in single or multiple visits. After the completion of the treatment, interim filling is placed. When further evaluation in three to six months shows no signs of reinfection, the filling can be replaced with the crown. More than 95% of times, this approach works well and infection heals within few weeks after treatment. In those cases, where infection does not subside or recurs in few months, extraction of tooth becomes essential. This step is then followed by the placement of spacer or space maintainer.
The possibility of failure of treatment is always informed prior to the parents so that they can have informed decision.
Advantages of lasers assisted dentistry is no more just limited to overcome the drill or needle phobia. Sterilization and healing benefits of Dual wavelength lasers in infected root canals, help to maintain primary dentition until the time of natural exfoliation. This allows the child to achieve the benefits of natural tooth to their full potential.
