Dealing with non-vital teeth
WHETHER it is caused by an accident while playing in the backyard or from tooth decay, children sometimes experience so much trauma to a tooth that it becomes non-vital or dead.
“Non-vital teeth, also known as necrotic teeth, are essentially dead teeth. The pulp in these teeth has been rendered irreversibly damaged and has died,” said dental surgeon Dr Naudia Gilzeane at Gateway Plaza, Old Harbour.
She pointed out that the teeth are usually identified by large fillings or a large cavity. Sporting incidents often lead to trauma or large fractures of the crown which is often discoloured (brownish, greyish). Teeth exposed to trauma are generally asymptomatic, but may occasionally present with pain.
“Treatment depends on a number of factors including the age of the child, the specific case presented to the dental practitioner, as well as the type of tooth – whether it is primary or permanent,” Dr Gilzeane outlined.
She said that the recommended treatment for non-vital primary teeth includes root canal therapy or extraction.
“Root canal therapy is indicated to try to preserve the tooth in the mouth in order to maintain the space until the permanent tooth erupts. The damaged pulp is removed from the crown and root of the tooth and the canals cleaned, after which they are filled with a resorbable material,” Dr Gilzeane explained.
Importantly, she noted that while dental practitioners try to avoid having to extract non-vital teeth, there are some cases in which the damage caused is irreversible.
On the other hand, in the case of children with non-vital immature permanent teeth, a process called apexification is performed.
“In this procedure, the damaged pulp is removed from the crown and root canal, after which it is cleaned and a filling material is placed that will permit a hard tissue barrier to form at the root apex or actually stimulate this formation,” Dr Gilzeane said. “Following the closure of the root apex, root canal therapy is completed with a standard root canal filling material and the tooth restored (filled).”
She noted that for mature permanent teeth, the pulp is removed and root canals are cleaned and then filled, followed by restoration of the teeth.
She advised that when considering treatment methods for non-vital teeth, it must be noted that the practitioner will go to great lengths to try to preserve the teeth where possible.
