Caring for Primary and Permanent Bicuspids: What You Need to Know

Caring for both primary (baby) and permanent bicuspids is a crucial aspect of dental health, particularly for those undergoing orthodontic treatments like Invisalign. Primary bicuspids, though temporary, pave the way for permanent teeth and play a significant role in the development of proper bite and alignment, which is especially important for patients using Invisalign. Good oral hygiene practices, including regular brushing and flossing, are essential to maintain the health of these teeth. For permanent bicuspids, which replace the primary teeth, maintaining their health is critical for overall oral function and aesthetics. 

A traditional bridge is a great way to close gaps between teeth, but unlike partial bridges, it is fixed and not removable. It adheres directly to the surface of the teeth that opposes the space. Fixed bridges may be preferred in certain cases, but they may be a little more difficult to clean and will generally require reducing certain healthy parts of adjacent teeth.

Primary molars

usually have the same number and position of roots as the corresponding permanent molars.

However, if an older child or teen has lost a permanent tooth or never developed one or more of their permanent teeth, it can be a stressful situation. AutoMatrix is a preformed loop made of stainless steel matrix material that is placed on the tooth and tightened with a special tightening tool that comes with the kit. Children can still lose teeth prematurely, so procedures aimed at preventing and treating pulp disease in permanent, primary and immature dentitions remain an integral part of contemporary dental practice. The roots of primary molars are comparatively thinner and longer than the roots of permanent molars.

To protect tooth development, it's important to consider performing a pulpotomy, apexogenesis, or even regenerative techniques. The AAPD guidelines for pulp therapy for permanent, primary and young teeth describe the pulpotomy procedure on primary teeth as amputating the affected or infected coronal portion of the dental pulp, preserving the vitality and function of all or part of the remaining root pulp. In children, interpreting radiographs can be complicated due to the physiological root resorption of the primary teeth and the incomplete formation of the roots of the permanent teeth. If inflammation has spread to root canal tissues, then the tooth should be considered a candidate for pulpectomy and root canal filling or removal.

Primary crowns are wider in the mesial-distal dimension compared to the length of the crown than permanent crowns. Pulpotomy techniques for partial preservation of pulp tissue are also presented as legitimate therapies in primary teeth, where young, well-perfused tissues are combined with the relatively transient nature of dentition to achieve success. In young permanent teeth, therapies strive to keep the apical pulp well perfused and resilient until root formation is complete. Black described several steps to prepare decayed permanent teeth for an amalgam restoration.

It has some of the same cleaning challenges as a fixed bridge, so it's essential to follow a proper oral care routine so that it works as it should. The results of studies on enamel defects in treated and untreated contralateral teeth are inconsistent. When deciding on the right treatment, it's important to consider the proximity of the primary tooth to its permanent successor tooth. ProRoot MTA is considered expensive because it is sold at retail in boxes containing several sealed packages of 1 g.

Eloise Cuttitta
Eloise Cuttitta

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