Dental Education Lecture: Baby Tooth Nerve Therapy

We have talked about root canal therapy for adult teeth.  Once the nerve (green) gets infected (red), no matter how small (Fig.2) or large (Fig.3), we need to remove all of the nerve and finish root canal filling (brown, 1, Fig.4), build-up (a form of filling, gray, 2) and crown (white, 3).  Since we need to keep an adult tooth as long as possible, we need a complete treatment, like root canal therapy.  After it, the root tip infection (red circle in Fig.3) resolves by itself (empty circle in Fig.4).

Compared to an adult molar (Fig.1), a baby molar is not only smaller ( Fig.5), but also there is a developing adult tooth (blue) underneath root branching area.  When nerve infection is limited (red, Fig.6), the dentist tries to remove nerve tissue from chamber above the arrowheads as much as possible, places a filling material (gray, Fig.8) and puts a stainless steel crown (SSC, black layer) for protection. SSC is a temporary crown, since the baby tooth is going to fall out in due time. If you want to see what a stainless steel crown looks like, please go to check Fig.4 of Toothbrush for Kids lecture for SSC.

Sometimes baby tooth nerve infection is quite extensive (red, Fig.7).  The infection extends outside the root tip (small red circle) and root branching area (large red circle).  Since the infection is pretty close to the developing adult tooth and it is not good for the latter, we tend to like to extract the tooth and place a space maintenance.  If your child is very co-operative, the doctor may take time to do baby tooth root canal: removing all of nerve tissue, doing root canal filling (brown), regular filling (gray) and SSC (black layer, Fig.9).  After complete treatment, infection resolves by itself in root tip (empty small circle) and root branching area (empty large circle).  We should follow up closely after treatment, since the infection may recur.  Anyway, children should go to dental office for exam on a regular basis so that there is a chance that we can find small cavities and fill them before causing nerve infection.  In contrast, cavities (black) are quite large in Fig.6 and 7 as well as in Fig.2 and 3.

Xin Wei, DDS, PhD, MS 1st edition 02/15/2009, last revision 02/16/2009