Ms. Liu: My son is 14 years old, and two days ago he accidentally broke his right incisor while playing ball on the playground. I took him to the hospital for root canal treatment, and the doctor said he can’t get a tooth until he is 18 years old. I would like to ask what can we do as parents between the ages of 14 and 18? Sun Huiqiang, Department of Prosthodontics, Shandong University Dental Hospital
Dr. Sun: First of all, I want to correct a problem: traditional textbooks believe that before the age of 18 is not suitable for porcelain crown restoration, which is what we call dental veneers; however, 18 years old is not an absolute contraindication to porcelain crown restoration, now advocate “early restoration”, that is, after root canal treatment should be crown restoration. Here we must emphasize that after the perfect root canal treatment, if the tooth is not completed, the apical hole is not completely closed, then the apical induction should be first closed apical hole and then root canal treatment, before the porcelain crown restoration.
It is true that, as age increases, the gums gradually recede, the original is located below the gums or and gums flush with the edge of the crown will gradually located flush with the gums or above the gums, black edge, affecting the aesthetics, so my advice is to do a cheap crown first, after 18 years old or affect the aesthetics, you can change a more expensive crown.
Waiting until you are 18 to get a second crown would be time consuming and expensive. Why would you suggest this instead of just fixing it at 18? The gap in the missing tooth can cause the opposing tooth to elongate and the neighboring tooth to tilt and shift to the side of the gap, especially in adolescents during the stage of establishing occlusal balance. This can eventually lead to loss of the restorative gap over several years, increasing the difficulty in restoration, requiring grinding and reshaping of the opposing teeth during restoration or restoring teeth that are too small for aesthetic purposes. For the problem of small restorative gaps due to tilted adjacent teeth, orthodontics can be used to restore the restorative gaps before restoration, but considering the extra cost, extra pain and time consumed by orthodontics. When comparing the two, it is not difficult to make a choice.
Another issue that must be taken into consideration is that the precious years before 18 are a critical period of growth and development for adolescents, and a stage of gradual psychological maturity. A missing incisor will not only affect the aesthetics of the child’s face, but will also affect the physical and even psychological health of the child, seriously affecting the child’s confidence in the future.