One of the most unfortunate situations I face is the treatment of children. Children end up in my practice for a number of reasons. These include developmental conditions such as dens evaginatus or trauma.
The most common reason I see children is caries. As an endodontist, by the time I see a child, caries has usually done a great deal of damage to the tooth in question. Often, this caries has been diagnosed by the referring doctor a significant time earlier.
In the following two cases, two 12 year old patients were seen and treated by me. Both of these patients had long standing diagnoses of carious lesions in tooth #30. Even though they both were covered by dental insurance since the initial diagnosis of caries, both young men presented with the following diagnosis on tooth #30:
Pulpal: Asymptomatic irreversible pulpitis
Periapical:Normal Periapex
As much as I enjoy writing, I believe these cases can tell the story much better than I can.
Neither one of these patients had seen their general dentist since their last visit with me. More than a year had elapsed.
The first patient was just seen this summer by his general dentist. Here are the radiographs:
This kind of outcome really breaks your heart.
The second patient still has not been heard from. Perhaps the immediate core placement will help prevent or delay a similar outcome.
We can always hope.
