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Abstract: The child came to the clinic with his parents because of a toothache. After questioning, we learned that the child had said that he had a toothache a long time ago, but did not pay attention to it at that time, and in recent days he often cried at night, saying that his teeth hurt and his face hurt, and sometimes he did not like to eat.
Basic information】Male, 5 years old
Disease Type】Pulpitis
Hospital】The First Hospital of Harbin Medical University
Date of consultation】February 2022
Treatment plan] Root canal treatment + composite resin bonding restoration technology
Treatment Period】Six months after outpatient treatment
Results】The pain was eliminated, the function and shape of the tooth were restored, and the diet returned to normal.
I. Initial Consultation
The child came to the outpatient clinic with his parents because of toothache. In recent days, the child cried a lot at night, pointing to the left side of his face and saying that his teeth hurt and his face hurt, but he did not say that it hurt during the day, but sometimes he did not like to eat. Thus, the diagnosis of pulpitis was confirmed.
II. Treatment process
Initially, the parents wanted to extract the tooth and wait for the tooth replacement, but considering that the child is still young and the milk tooth plays a very critical role in his growth and development, root canal treatment was recommended so that he would not be missing a tooth for several years before the tooth replacement eruption. After hearing the explanation, the parents agreed to undergo root canal treatment. Root canal treatment is usually completed in 2-4 sessions. Considering the inconvenience of multiple trips for the child coming from far away, a one-time completion of root canal treatment was chosen to reduce the hassle of visiting the doctor. The treatment was performed under local anesthesia with a dental drill to remove the decayed material, followed by pulp opening and extraction, root canal preparation, followed by root canal filling with paste, and finally restoration of the tooth with composite resin bonding restoration technique.
III. Treatment effect
The root canal treatment was completed on the same day of the visit, and the radiographs of the tooth taken after the treatment showed that the root canal was filled without any problems. After the composite resin filling, the filling material was also sanded and polished to ensure that there was no discomfort when the child’s tooth was occluded. The child had a slight toothache on the day of treatment and on the second day, which was a normal root filling reaction, and the pain was quickly eliminated, and there was no more toothache or crying at night. The child is recommended to have a follow-up visit every six months to detect possible problems and treat them in a timely manner.
IV. Notes
We are glad that the child’s painful symptoms have disappeared after treatment, but after the treatment is completed, the family should help the child to do the usual oral cleaning work and gradually teach him/her to brush independently while helping him/her to brush. In daily life, it is also necessary to pay attention to not eating sweets and not drinking sugary drinks or drinking less. Families should also observe whether there are black spots, yellow spots and defects in the teeth of the children, which may be the manifestation of dental caries and should be treated in time to avoid the progression to pulpitis.
V. Personal insight
Pulpitis is a common disease in the oral cavity. Compared with the permanent teeth, the baby teeth are easy to get caries and the caries of baby teeth develops quickly, so pulpitis is more prevalent among children. Many parents think that toothache in children can be cured by tooth extraction, but this is a misconception. The treatment of pulpitis is mainly root canal treatment, and tooth extraction is only done when the tooth is about to be replaced or when the situation is too serious to keep the replacement tooth. Tooth loss can have a great impact on life, so when toothache occurs, you should go to the dentist in time, on the one hand, and listen to the doctor’s advice not to blindly extract the tooth. In this case, the child and the family were willing to cooperate with the treatment and achieved good results, which is the most desirable result as a doctor.