Milk teeth want excellent treatment, too

Child-specific treatments maintain important dental functions

Fillings, crowns and root treatments may also be recommended for milk teeth. You might think that milk teeth are not that important because they fall out anyway. But they are important:

  • for learning to speak 
  • for chewing
  • for laughing and smiling
  • as placeholders for subsequent permanent teeth

Treatments for milk teeth prevent misalignment

Many people are unaware of the placeholder function of milk teeth. If milk teeth are lost early through an accident or caries, neighbouring teeth can move into the gap. Then the subsequent permanent teeth do not have enough room to come through. Now they push up against their neighbours, too. This often results in uneven teeth, jaw misalignment and lots of appointments at the orthodontist. Or we can try to save and repair the damaged milk teeth through dental treatments specifically for children.

Caries must go

Cases of caries in children have become much rarer over the last few decades thanks to dedicated preventive dental care. However, caries caused by drinking from babies’ bottles is still very common among small children. Bacteria that cause caries have a field day when sugary drinks from babies’ bottles are constantly washed round the teeth. 

Once caries is identified in a child, it is important to carefully remove the carious substance right away. This prevents the damaging bacteria that cause caries from spreading further around the teeth, mouth and body. The hole in the tooth is given the best possible treatment at Dr. Christina Jürgensen’s paediatric dental practice – regardless of whether it is in a permanent tooth or milk tooth.

Fillings for carious milk teeth

After the carious part of the tooth is removed, we seal the little hole with a filling. We only use well-tolerated materials like glass ionomer cement or plastic fillings here at Dr. Jürgensen’s paediatric dental practice in Nuremberg. Parents decide together with the paediatric dentist which filling material is best suited to their child:

  • A “cement filling” (glass ionomer cement) is light yellow in colour. It is softer than plastic and so it wears out more quickly. The health insurance provider covers all the costs.
  • A “plastic filling” (composite or compomer) is tooth-coloured. The filling is “glued” into the tooth in layers. This makes it particularly stable and more durable than glass ionomer cement. Plastic fillings can be applied in combination with fissure sealant. The health insurance provider covers part of the costs.

Rubber dam – our “umbrella” for treated teeth

A rubber dam is a flexible, medical rubber sheet. It is stretched over the teeth and secured with a clip. Only the teeth to be treated are left exposed. They are perfectly shielded from saliva and bacteria from the mouth. It is important, for instance, to keep the teeth absolutely dry when fissure sealant is being applied.

The “umbrella” in the mouth can take some getting used to at first, but provides numerous benefits for your child. The rubber dam is a feature of the excellent treatment provided at Dr. Christina Jürgensen’s paediatric dental practice in Nuremberg. It:

  • keeps teeth dry, which facilitates successful and high-quality treatment

  • protects the tongue, lips and cheeks, e.g. from substances which don’t taste nice

  • prevents mouth rinse, tiny pieces of old fillings, crowns, etc. being swallowed

  • helps reduce the gag reflex

  • makes it easier for the child to keep their mouth open for longer thanks to the tension of the rubber sheet

Crowns for milk teeth – shining suit of armour for poorly teeth

Even heavily decayed milk teeth that cannot hold a filling can be restored with a paediatric crown. Molar milk teeth are given a type of silver suit of armour to ensure they are still good at chewing and are protected from further caries. This is a pre-fabricated crown made from medical grade stainless steel. We apply “invisible” crowns to the milk teeth at the front of the mouth. These are made from tooth-coloured plastic or ceramic and are firmly bonded to the tooth using special bonding techniques. Visually, there is little to tell them apart from healthy teeth.

Crowns for milk teeth act as placeholders and ensure the chewing function is maintained in the case of:

  • deep or extensive caries
  • root-treated teeth
  • teeth with an enamel defect
  • severely damaged permanent teeth as a longer lasting provisional solution until a permanent crown can be produced in the dental lab and then fitted

Crowns for milk teeth do not require impressions, extra time at the dental lab or extra costs and can be prepared and fitted in one appointment. The health insurance provider covers all the costs for stainless steel crowns for milk teeth and part of the costs for tooth-coloured crowns for milk teeth.

Nerve treatment – last resort for poorly milk teeth

Even milk teeth can sometimes experience frayed nerves. This happens quite easily, because the enamel is quite thin and the nerves take up a comparatively large space. So caries is able to quickly eat through into the interior of the milk tooth. Even if the hole is still very small, this can lead to an inflammation of the milk tooth nerves. What is required then is nerve or root treatment (endodontics) in order to save the tooth. This involves carefully removing the inflamed tissue. When it comes to performing endodontics on a milk tooth, a “partial root treatment” is usually sufficient. This keeps the milk tooth alive. Only very rarely is a “complete root treatment” required (this is what adults have). All cavities are then carefully disinfected and tightly sealed. A crown for a milk tooth ensures that the tooth maintains its stability.

While even just hearing the word “root canal treatment” can make adults go weak at the knees, our young patients remain astonishingly brave and relaxed. That is because Dr. Christina Jürgensen’s paediatric dental practice in Nuremberg has a whole range of calming methods at its disposal to make even an endodontic treatment a nice one.

Space maintainers – this spot is taken!

If milk teeth are lost early, there is a risk that the back teeth may tilt or move into the gap left behind. In order to prevent other teeth from stealing that spot, we insert a little space maintainer. Depending on where and how many milk teeth are missing, we might recommend either a fixed or removable placeholder. Your dentist will decide together with you what is best in your child’s individual case. The important thing here is to ensure that despite of the missing milk teeth the jaws develop healthily and the permanent teeth can grow straight into their correct positions.

MIH – when teeth are stained and sensitive despite brushing

The abbreviation MIH stands for “molar incisor hypomineralisation”, which is a bit of a mouthful! This is a defect of the enamel which usually occurs on permanent molars, but sometimes affects incisors too. The exact causes are unclear. MIH is often identified by yellowish-brown or white dots that cannot be removed despite even the best efforts with brushing. Affected teeth are often particularly sensitive to touch and temperature. Teeth with MIH are also susceptible to caries and damages at the dental hard tissue. A fissure sealant or regular fluoridisation may be advisable to protect teeth with MIH. Careful check-ups and consistent prophylaxis are recommended in all cases. 

If you discover any suspicious staining on your child’s teeth, book an appointment to see us at Dr. Christina Jürgensen’s paediatric dental practice in Nuremberg. A paediatric dentist will check whether or not it is MIH and will advise you and your child on any hygiene or treatment required.


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