Treatment of milking elements - Pediatric Dentistry
Treatment of milking elements
Whether treatment of milking elements is necessary and which treatment must then be carried out depends on the age of the child.
- Children up to 4 years old cannot understand that treatment is needed. The chance that they do not cooperate is high. Therefore it may be wise to postpone curative treatments (if possible) until the fourth year of life. Of course pain complaints must be avoided. It must be prevented that toothache becomes the first real treatment acquaintance with the dentist.
- A child can be treated from 4 to 7 years old. The child understands the purpose of the treatment and also understands that the treatment is soon over.
- From 8 to 11 years old, dental development is examined to determine whether treatment is required. If the time until the change is less than a year, it is sufficient to only grind a small cavity in a milking element. Elements with large cavities are extracted. Other cavities are filled.
- If a child is 12 years or older and he still has milk elements, these are extracted in the event of complaints.
Restoration of milking elements
Because milking elements have a thin glaze cap, there is less support for filling materials and secondary caries are formed (caries along the edge of a filling). There is also a breakage of the thin glaze walls. By using a good dentine primer for restoration and keeping the preparation as small as possible, these problems can be prevented. Furthermore, the restoration of milking elements does not differ from that of permanent teeth.
Crowns can be chosen for extended cavities. These are metal ready-made crowns, which means that they are available in standard sizes. Crowns in the milk teeth are mainly made on the second milk mills. If these are lost prematurely, the first remaining molar tends to grow mesially. This creates a lack of space and may require orthodontic treatment.
Endodontic treatment of milk elements
A complete nerve channel treatment is not done with milk elements. To change, the root must be able to resorb (dissolve). When preparing a deep cavity, an indirect covering or pulpotomy is chosen if possible. A pulpotomy or vital amputation is an amputation of (a part of) the crown pulp for milk elements. The goal is to preserve the vitality of the residual pulp. The channel entrances are covered with a cement based on calcium hydroxide or MTA. This stimulates the pulp in the root canal entrances to form a dentin bridge.
Extractions are mainly made if an inflammation has occurred or if a simpler treatment is probably not having the desired effect. The element must also be removed with painless inflammation, for example with fistula formation. This prevents damage to the underlying remaining element by the inflammatory tissue. There are special extraction tongs for milking elements that match their morphology.