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Dentistry/Alternative to RCT


QUESTION: "Sir/Madam
1)My grandson is just 6 years and VERY NAUGHTY.For some problem my dentist has advised RCT for 3 baby teeth.But the problem is that he may not cooperate and more trouble may be faced.But Root canal treatment for  teeth in children is a complex procedure requiring lengthy appointments and multiple visits .
2)If alternatively PRIMARY TOOTH IS EXTRACTED  however, space maintainers would have to be used to preserve the space of the extracted teeth.
3)If there is no alternative to RCT In extreme cases, sedation/ general anesthesia may be  an alternative to facilitate RCT
 Xylitol is an  alternative for  patients to  manage recurring cavities easily,.Whether chewing xylitol gum, eating cheese and rinsing with water after meals may all play a role in reducing bacteria, neutralizing acids in the mouth and preventing tooth erosion.
  Whether for a 6 year old boy Xylitol should be taken  as chewing  gum.
   Please help with your answer"

ANSWER: Kalyan-Xylitol as a sugar substitute helps to prevent decay to some extent, but it can also produce problems, such as stomach gas and diarrhea.  So there is a trade off with every substance.  The best thing to is not to stop substances but reduce their usage and and do very good oral hygiene to better control oral bacteria and decay

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QUESTION: Only you have answered about Xytilol,what about other points.Please help

Kaylan, if the teeth have internal infection or inflammation, those aspects need to be removed to prevent damage to the underlying permanent teeth.  I am not opposed to anesthesia or sedation to make the children more cooperative and less fearful.  A skilled pediatric dentist can quickly do a proper root canal treatment for a child.  Unlike an adult a simple procedure can basically make the tooth inert so no negative effects on the underlying permanent teeth can occur and the space is maintained for future eruption of the teeth.

If however the extent of decay is extensive, the teeth or the unsalvageable tooth should be extracted to prevent a periodontal inflammation or infection cause damage to the underlying permanent tooth. So each case should be evaluated on the health of the child, the extent of decay and the existing damage to the gums and bone in the area.  I wish I. Would give you a more definitive answer, but a full examination and trays of the area would better define the various needs.

I am not against anesthesia for a healthy child.


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Joel S. Teig, DMD, Diplomate ABOMS, retired


I am a board certified oral and maxillofacial surgeon and I am available to answer questions related to tooth extractions, implant insertion, facial recontruction, facial and oral tumor removal, TMJ dysfunction and various successful treatments, including surgery if all else fails, and occlusal discrepancy requiring orthognathic or jaw surgery.


Board Certified Oral and Maxillofacial Surgeon practicine for over 20 years. Assistant Clincal Professor and State University School of Dentistry.

American Dental Association, American Association of Oral and Maxillofacial Surgeons, American Board of Oral and Maxillofacial Surgeons

BA -University of Connecticut DMD - University of Pennsylvania School of Dental Medicine

Awards and Honors
National Honor Society (OKU), Philadelphia County Dental Society, Mosby Book Award, Oral Surgery Honors, Summa Cum Laude

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