Pulp Gangrene in Children: Management and Challenges in the Dental Awareness Program

From August to November 2024, the Westerlaken Foundation team conducted dental health check-ups for children in 45 schools across Bali. Out of the 2,881 children examined, 663 cases of pulp gangrene were detected. Pulp gangrene in children is a significant concern because it can interfere with their health and development, especially when untreated dental infections are left unmanaged. This article explores the causes, symptoms, diagnostic methods, treatments, and challenges involved in addressing pulp gangrene in children.

Pulp gangrene occurs when the pulp tissue inside the tooth dies or suffers a severe bacterial infection. Due to the thinner enamel layer and immature tooth roots, this condition can progress more rapidly in children than in adults.

Causes of Pulp Gangrene in Children

The primary causes of pulp gangrene in children vary widely. Some of the main causes include :

1. Caries Infection

2. Dental Trauma

3. Bacterial Infection

   
   

   

   
   

Symptoms of Pulp Gangrene

In its early stages, pulp gangrene may not show prominent symptoms, making it difficult to detect. However, as the condition progresses, the following symptoms can appear :

1. Severe Pain

   Children may experience acute tooth pain that comes and goes, which can become very intense.

2. Gum Swelling

   Swelling occurs around the infected tooth. Sometimes, pus may form around the swollen gums, worsening the infection.

3. Sensitivity to Temperature

   Children may experience heightened sensitivity to hot or cold foods or drinks, causing pain.

4. Bad Breath

   The bacterial infection inside the tooth can cause an unpleasant breath odor.

   
   

   

   
   

   The Connection Between the Dental Clinic Program and Pulp Gangrene

   
   

   The Westerlaken Foundation Dental Clinic program is closely linked to addressing pulp gangrene in children in Bali. Through regular check-ups in 45 schools in Bali, the Dental Clinic has successfully identified pulp gangrene cases in 663 out of 2,881 children examined. These in-school examinations allow early identification of pulp gangrene, helping to catch infections before they progress to a point where more invasive procedures, like tooth extraction or root canal treatment, are necessary.

   
   

   This program not only provides examinations and treatment but also includes educational sessions on oral hygiene for children and parents. The Westerlaken Foundation Dental Clinic offers specific services to address infected children’s teeth, including applying medicated dressings for mild cases or recommending referrals to more comprehensive healthcare facilities for root canal treatments. Through appropriate intervention, the program helps prevent the spread of infection and reduces the risk of more severe gangrene.

   
   

   

   Overcoming Access Barriers to Dental Health Services

   
   

   In support of dental health access in underprivileged areas, the Westerlaken Alliance Indonesia Foundation reaches regions where access to dental health services is limited. This access is crucial, as health facilities in schools or remote areas are often limited, leaving many cases of tooth decay neglected, risking progression to pulp gangrene.

Overall, the Westerlaken Foundation’s Dental Clinic Program plays a crucial role in preventing and addressing pulp gangrene in children in Bali. Through examinations, education, treatment, and wider access to dental health services, this program helps protect children's oral health while sustainably supporting their overall health.