２歳11ヶ月の娘です。前歯二本を虫歯治療しました。
- ２歳11ヶ月の娘です。
前歯二本を虫歯治療しました。初めての治療のときは麻酔もせずレジンで埋めてすぐに治療が終わったのですが何度も付けては取れてそのたびに削るので、とうとう前歯に被せ物をしました。
遠方の実家に帰省中に詰め物が取れたので実家近くの小児歯科専門医で被せ物をしてもらい、今は近所の小児歯科専門医に２ヶ月に一度通っています。
今その被せ物をした歯がぐらついています。フロスをすると歯が動いているのがわかる位のぐらつきです。1、２ミリ程でしょうか。本人も歯がグラグラしてるのがわかるようです。
被せ物をしたあと一度歯茎が膿んだのですが神経の処置はせず、投薬で様子見しました。
今通っている歯医者は治療が出来るまで様子見が基本です。
このまま様子見でも大丈夫なのでしょうか？
ちゃんと永久歯が生えてくるのか不安です。 - こんにちは！三木照久歯科、院長の三木照久です。
ご相談の件ですが…いただいた内容から推測すると、かなり虫歯が進行していると考えられます。平均的な小児のお口の状態から考えると、かなり進行が速いといえます。
治療内容に関しては、そのご年齢からおそらくまだご本人の協力性が低く、病気の進行に対して本来行うべき本格的な治療ができず、「いまできる範囲で」懸命に診て下さっている様子が伺えます。これは、いま診て下さっている小児歯科専門医の先生だけではなく、元々診て下さっていた先生に対しても…です。
そしてその後の経過についても、(起こって欲しくはないことですが)その都度起こり得ることが起こっている…と感じます。
過去に、いま心配されている歯に外傷(こけて口元あたりをぶつける等)の既往(ご経験)はありませんか？もしそう言うことがあると、その時歯の中の神経が死んでしまっていたり、亜脱臼(例えて言うと、ネジが抜けてはいないが少し緩んだような状態)を起こしていたり、ヒビが入ることで虫歯になりやすくなったりということも考えられます。
逆に、そのようなお心当たりがない場合は…原因は様々(体質や環境等)ですが、お子様の前歯に関して、平均より虫歯リスクが高い可能性も心配します(例えて言うと、「お腹を壊しやすい」とか「風邪をひきやすい」といったものの歯バージョンです)。
いずれにしても、(直接拝見しておりませんので断定的なことは申し上げかねますが)当該歯にもし本格的な治療を行うとすれば、現時点では「歯の神経を取る」治療になる可能性が高いと思われます。
一方、一般的には先に述べた協力性の問題からすぐにその治療を行うことがかなり難しいことも事実です。
ですが、前歯となると(部位にもよりますが)幼稚園を卒園する頃か小学校低学年まで、できれば役目を果たして欲しい歯で、その状態は永久歯にも影響を与える可能性もあり、「いまのままで大丈夫なの？」と心配される保護者様の気持ちも胸が痛いほどよく分かります。
選択肢としては、もう少し協力性が高くなるまで慎重に状態を拝見しつつ、それまでは状態によりその時できる治療を行うことで対応する…定期的に観察を続けることはご本人の歯医者への「慣れ」、協力性の向上にもつながる…これを続けつつ、できるだけ早く本格治療に移行する。これが、多くの先生が選ばれ、提案される方法ではないかと思います。
それでは心配だなと思われるなら、一度大学病院の小児歯科等に紹介していただき、他の選択肢がないか意見を伺う、という選択もあるかも知れません。
医科と違い、歯科はどの都道府県にも大学病院があるわけではありませんが…不幸中の幸いで愛知なら…お住まいの場所によっては一つないし二つ…通院可能な大学病院があるかも知れません。ただ、大学病院でも同じご提案になる可能性もあるかと思います。その点ご理解下さい。
いずれにしても、診て下さってる先生と注意深い観察を続け、ご相談されることが必須と思われます。1日も早く、ご本人と保護者の方が安心されるよう願ってやみません。
では、本当にお大事になさってくださいね。
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