Milk Tooth Filling
It is a treatment method that aims to restore the tooth tissue lost due to decay or fracture, to relieve the existing pain of the tooth, to restore the function and lost aesthetic appearance. Compomers known as children’s fillings can be used for this procedure, as well as composite fillings. If there is decay, it is cleaned, and only edge corrections are made for broken teeth. Generally, there is no need for local anesthesia for tiny decays of milk teeth. In cases where the pediatric patient and the physician are compatible and can act together, the decay at the initial level of the milk tooth can be cleaned and filled quickly. Especially in front tooth fractures, anterior aesthetic fillings can be preferred and fillings that are compatible with the tooth tissue and whose transitions are not obvious can be made.
Milk Tooth Amputation
When cleaning advanced caries, the pulp of the tooth may be exposed. If the pulp of the deciduous tooth in the root area is not yet infected, amputation treatment can be performed. In this treatment, which resembles a half canal treatment, the pulp corresponding to the part where the roots are located is considered healthy and is fixed with the help of medication and the vascular and nerve tissue inside the roots is left. The coronal pulp is amputated (cut out). This treatment method requires local anesthesia. The treatment is completed by placing the relevant filling materials into the cavity (cavity) formed as a result of the partially removed pulp and cleaned caries. In order to perform amputation treatment, it is essential that the inter-root area is radiographically healthy. Otherwise, root canal treatment is appropriate.
Milk Tooth Root Canal Treatment
Advanced caries can reach the pulp of the deciduous tooth and infect it. In this case, root canal treatment is necessary. However, in order to perform root canal treatment on deciduous teeth, abscess formation must not have developed in the inter-root area. If abscess formation is detected, extraction of the deciduous tooth is appropriate. However, as much as possible, root canal treatment should be performed on deciduous teeth in order to preserve their position until the permanent teeth erupt.
If it is determined that the deciduous tooth is suitable for root canal treatment as a result of radiographic and clinical examination, the entrance cavity is formed by cleaning the decayed parts of the tooth following local anesthesia. During root canal treatment in deciduous teeth, the nerve is removed by leaving a safe distance of 2 mm from the root tip, filed, washed, disinfected and dried. The prepared canals are filled with a resorbable canal filling paste. In this way, while the permanent teeth are erupting, the root of the deciduous tooth melts along with the canal paste and does not create an obstacle to the eruption movement. The top of the root canal treatment is usually covered with composite, but some teeth may lose too much material and it may be necessary to protect the tooth by covering the filling with a stainless steel crown.
Infected teeth that cannot be saved with root canal treatment may need to be extracted and replaced with placeholders. Long-lasting abscesses and chronic infections in the roots of deciduous teeth can cause permanent teeth that are trying to erupt under the deciduous teeth to be affected, causing color and developmental disorders in permanent teeth.
Fixed and Movable Placeholders
While there is still time for the permanent teeth to erupt, space maintainers are made to protect the space of the milk teeth that have to be extracted prematurely and to prevent space constraints for the permanent teeth that will erupt from below. Space maintainers can be fixed or movable. While fixed placeholders are generally preferred for single missing teeth, removable placeholders are suitable for multiple missing teeth. For the construction of both types of placeholders, an oral impression is required. Removable retainers are similar to adult partial dentures, they are removable and can be fitted and adjusted by rehearsal. As the jaw development of growing children continues, removable placeholders will become incompatible over time. Therefore, frequent follow-up appointments are arranged in proportion to the growth curve. At these appointments, the removable placeholders may need to be adjusted or renewed. Fixed placeholders consist of a band and a wire soldered to it. The band is glued to the tooth, while the twisted wire on the band must be placed against the other tooth adjacent to the gap. In this way, the gap distance is fixed. Both types of retainers have a high potential for fractures in pediatric patients. In case of fracture or dislocation, it is useful to consult the physician again urgently.
Stainless Steel Crown
Stainless steel crowns may be necessary for teeth with excessive loss of material. If necessary, the tooth is filled after the decay is cleaned. The tooth is then prepared to remove the contact with the neighboring teeth. After the tooth is made suitable, impressions are taken from the upper and lower jaw. The stainless steel crown is prepared in the laboratory in accordance with the impression and bite. It is rehearsed, adapted in the mouth and adhered to the tooth.
Protective Fluorine Varnish Application
It is a preventive dentistry practice. It is applied every 6 months to all existing teeth. It is aimed to make teeth more resistant to decay by applying it to dried tooth surfaces. It is not recommended to apply in the presence of any febrile infection. Depending on the type and brand of fluoride applied, it is recommended not to eat anything for 1-4 hours. It is generally recommended to brush teeth without toothpaste or use fluoride-free toothpaste on the evening of the day of application.
Fissure Sealant
Fissure sealant is recommended in the presence of deep fissures and pits that increase the risk of tooth decay and/or in cases where the patient’s caries incidence (caries potential) is high. Covering the tooth surfaces with a high risk of decay with fluorine-releasing or non-fluorine-releasing filling materials ensures that the deep areas on the tooth that are suitable for bacteria and food retention are closed and shallowed. With this application, areas where bacteria can attach and progress (pits and fissures) are covered with protective filling material.
This application is usually applied to the 1st molars (1st molars), also known as 6 year old teeth. They are difficult teeth to clean because they are located at the back of the tooth row and erupt at an early age. If necessary and if the patient needs it, it can also be applied for milk molars or early erupted 2nd molars.
Milk Tooth Extraction
If the infection in the root of the tooth is too large to be treated or if the decay in the tooth has expanded into the root area and has progressed to the point of separating the roots, the tooth must be extracted. By extracting the tooth, the tooth or root that is the source of infection is completely removed from the body.
Tooth loss is undesirable, so it is always evaluated whether the teeth can be treated with filling or root canal treatment. If the infection in the tooth is too advanced to be treated, extraction will be inevitable to prevent further spread of the infection. Infected deciduous teeth that are not extracted in children can damage the development of the permanent teeth coming from below. Infection can cause discoloration of the permanent tooth or retarded enamel development (enamel hypoplasia). The remaining root fragments of the deciduous tooth may prevent the eruption of permanent teeth or deviate their direction.
After the extraction site is numbed with local anesthesia, the tooth or root is extracted and a gauze tampon is used to control bleeding. The bleeding usually stops after biting the gauze for a while.
Riding Guidance
Application of riding guidance may be necessary in the presence of deciduous teeth that are partially spaced and do not change on time. In this treatment method, after the radiographic control, the extraction of the primary teeth is planned in the appropriate order according to the eruption order of the permanent teeth, their root development and the distance between them and the root of the primary teeth. With the extraction of milk teeth, it is planned that the permanent teeth will descend into the oral cavity without attachment or compression. This process is called “Riding Guidance”.
