Although the classification of deciduous rickets is diverse, the clinical diagnosis is mainly based on lesions and specific clinical manifestations. Therefore, the diagnosis of deciduous rickets in children is generally not difficult, but it is not easy to accurately diagnose each type of rickets. Special inspections with higher accuracy should be selected according to the conditions.
Enamel enamel, generally without any symptoms, the pit and groove gap is brown and difficult to remove, the roughness of the probe or the tip of the probe can be slightly inserted, sliding resistance. For adjunctive facial paralysis that is difficult to diagnose, it is often necessary to combine x-ray film and light transillumination to confirm the diagnosis.
The dentin is shallow, the pain is different from person to person, the deciduous teeth are not obvious, there is no spontaneous pain, the cavity is medium depth, the food residue is retained in the hole, the pain and temperature stimulation are not as obvious as the young permanent teeth, and the bottom of the hole is yellow brown. Or a tan or brownish black soft palate.
The dentin is deep, the pain is more obvious than that of the middle, and the food enters the cave with severe pain.
Classification of pathogenic rickets:
Secondary childhood rickets
After filling and repairing, the edge of the hole or the bottom of the hole is recurring. With or without a history of filling, the secondary sputum in the cave can be diagnosed by routine visual inspection and probing, and the wall or the bottom of the cave is diagnosed by X-ray film.
There is a history of sweetening or emotional stress, and the clinical manifestations are characterized by acute progressive rickets in multiple teeth in a short period of time. Often involved in the mandibular anterior teeth that are not susceptible to sputum.
Bottle child rickets
Have a bad habit of drinking milk or breastfeeding before going to bed at night. The clinical features are: the smooth surface of the maxillary milk incisor and the extensive occlusion of the maxillary first deciduous teeth and the incisors are innocent.
Clinically, the annular lesion around the 1/3 of the crown of the maxillary anterior teeth can be diagnosed.
When the diagnosis of rickets is diagnosed, the rickets should be treated for the cause of rickets. The purpose of treatment for children with rickets is to stop the development of rickets and protect the activity of the pulp. For the early enamel enamel that has been demineralized and the hardness is reduced, the tooth surface is treated with a specially formulated remineralization solution to re-deposit the calcium salt to repair the rickets in children. Prevention by brushing teeth and other plaque removal.
1. Blocking treatment of children with rickets
Refers to not cutting or cutting the damaged tissue of the tooth, and only applying appropriate drugs to the damaged part to stop the development or disappearance of the loss.
Scope of application:
It is not easy to prepare cave-shaped deciduous teeth with a wide range of shallow or spalled ring-shaped sputum; the common anterior and posterior nipples of the anterior teeth, the occlusal surface of the deciduous teeth and the buccal surface.
1) De-corrosion and no base glaze or sharp edges, trimming the shape and forming a self-cleaning area.
2) Clean the tooth surface.
3)) Applying medicine. Repeated rubbing for 2 to 3 minutes, 1 to 2 courses per week, 3 minutes after the application of fluoride, do not brush your teeth.
2. Remineralization for children with rickets
An early enamel method for treating early enamel enamel that has been demineralized and having a reduced hardness, treating the tooth surface with a specially formulated remineralization solution to re-deposit the calcium salt, and restoring the hardness of the enamel:
(1) Scope of application
Early enamel enamel on smooth surfaces of deciduous teeth; preventive for high-risk children with rickets.
The main components are fluoride, calcium and phosphorus.
For daily use as a bismuth-containing agent: when used as a topical smear, first clean the enamel leukoplakia area, melt and dry, place it in a white spot with a small cotton ball, and rub it repeatedly for 2 to 3 minutes. Apply 1-2 times a week, 3 weeks of treatment, and improve the oral health of the child.
3. Repair and treatment of childhood rickets
Deciduous deciduous teeth can reduce the chewing function. When the deciduous teeth are severely damaged, the length of the deciduous teeth can be shortened and the occlusion height is reduced, which has adverse effects on the normal growth and development of the maxillofacial region and the formation of permanent teeth. The diseased tissue is removed and the tooth morphology is restored. It is important to improve the repair of chewing function.
(1) filling treatment for children with rickets
It refers to a method for removing damaged tissue, preparing a cavity of appropriate size and shape, and filling the cavity with dental material to restore the shape of the tooth under the condition of protecting the pulp.
1) Preparation of the cavity
The basic principle is the same as permanent teeth.
2) Repair of tooth tissue:
Because of the enamel of the deciduous teeth, the dentin is relatively thin. Anyone below the middle layer of the dentin should be bottomed first; the bottom material should be non-irritating to the pulp; while considering the existence of the physiological gap of the deciduous teeth, it is not necessary to regain the contact point; When the crown is broken, care should be taken to restore the height of the occlusal joint.
(2) Inlay restoration
In the past, amalgam inlays were mainly used, and the application of composite resins has increased in recent years.
4. Non-traumatic repair for children with rickets
(1) Indications for ART
It can be accessed by hand with no pulp, no permanent tooth and deciduous enamel of suspicious pulpitis, and filling treatment of dentin. ART is mostly used for the filling of single-sided holes. The success rate is related to the size and shape of the hole.
(2) Advantages of ART
1) Hand instruments are simple and convenient, and do not require expensive electric powered oral equipment.
2) Minimal hole preparation is required to remove only demineralized teeth.
3) ART does not use a rig, which reduces pain and reduces the risk of local anesthesia.
4) Control cross infection.
5) The material is glass ion which reduces the requirement for the retention type and can release fluorine.
(3) ART's operation step by step
1) The body position of the withered body is prepared for the mouth. (Cleaning the tooth surface, detoxifying, cleaning the cavity) 2) Disposal of the cavity and the occlusal surface. 3) Adjust the GIC (glass ionomer cement) and fill it to check the occlusal joint.