Pulpotomy / Pulpectomy
Does My Child Need A Pulpotomy?
Has your child complained of pain or sensitivity? Does your child have deep cavities? Is their existing dental work starting to show staining around the edges of the restoration? While none of these immediately mean a pulpotomy is necessary, the chances it being the treatment of choice is very high. Once a baby tooth is infected with bacteria, the only way to remove it is by removing the decay that is infecting the pulp (nerves and blood supply to the tooth). In baby teeth, if we catch the disease early enough we can do a fairly quick procedure to save the tooth, and only some of the pulp has to be removed (the top part). Since the pulp in children’s teeth is much closer to the surface of the tooth than an adult’s tooth, cavities more rapidly progress and need pulpal intervention (pulpotomy/pulpectomy).
What Is The Difference Between A Pulpotomy And Pulpectomy?
Pulpotomies and pulpectomies are very similar. The difference is a pulpotomy procedure involves removing the pulpal tissue only in the crown of the tooth. In a pulpectomy, the tissue is removed in both the crown and the root of the tooth. Both procedures provide the benefit of sparing tooth loss when tooth preservation is desired. Both procedures are preformed painlessly with the help of local anesthetics.
If the child’s tooth has been diagnosed with a deep cavity, and the cavity hasn’t progressed so far that the tooth must be extracted, our options are either a pulpectomy or pulpotomy, followed by a stainless steel crown (for lasting protection from more bacteria entering the pulp/root). If the cavity is close to the pulp, we must make a decision whether to do a pulpectomy or pulpotomy after the tooth has been numbed (given “sleepy juice”) and opened by the dentist to check the status of the pulp. Since X-rays can only see hard tissue, it’s impossible to find out the pulpal condition (diseased or dying) until we check inside the tooth. If there is radiolucency around the tooth on the x-ray, however, we know the tooth will need to be extracted or have a pulpectomy.
How Is A Pulpotomy Performed?
We often use the aid of safe, relaxing conscious sedation to make the entire procedure worry-free for all of our children patients. A pulpotomy is done by removing diseased pulp tissue in the crown of the tooth. In order to calm any remaining nerve tissues in the tooth, a disinfecting medicated agent is placed inside the tooth. This will normally be followed by the placement of a baby crown such as a stainless steel crown. If the tooth is only going to be kept for a few months longer, we may decide to place a more temporary restoration, or extract the tooth and place a short-term space maintainer if needed. If the tooth is very close to exfoliating on its own, a simple extraction will be performed since a pulpectomy will have little benefit cost-wise to the patient/parent. Rest assured, these decisions will be made prior to the procedure during the initial consult. We don’t like surprises either.
What Can I Expect If My Child Needs A Pulpotomy?
Dr. Parsi will discuss the risks and benefits of the procedure with you beforehand. Any and all questions will be answered. Prior to the procedure, the area will be numbed or sedation will be administered depending on recommendations for your child. The dentist will use a drill and other instruments to extract the diseased portion of the tooth. Damaged pulp will be removed and medication placed over the remaining area. This is followed by a temporary filling. If the tooth is a primary tooth, a crown may be placed on the tooth. Some minimal discomfort may occur following the procedure. You will be instructed on managing any soreness in the mouth or signs of concern to watch for post procedure.
How Reliable are Pulpotomies?
A pulpotomy procedure is very effective and reliable. There is a good chance it will be successful in preserving the life of the tooth until it is time for the tooth to fall out and the permanent teeth to come in. There are little to no risks associated with the procedure. In some cases, the tooth may be abscessed or decayed too extensively for treatment. In this case, the tooth will need to be extracted.
The goal of a pulpotomy is the same as a pulpectomy. Both procedures are done to preserve a baby tooth and keep it healthy until it is time for the tooth to fall out naturally.
Dr. Parsi and his wife have been delivering gentle pediatric care for over 17 years. If you have questions about nerve/pulp therapy, or want to find out if your child needs a pulpotomy/pulpectomy, call or come visit Parsi General & Children Dentistry in San Antonio and we’ll gladly answer any questions you might have! Parsi General & Children Dentistry – Proudly offering pediatric dental services and adult dental services such as dental veneers, dental implants, teeth whitening, Invisalign, and comprehensive family dentistry to the San Antonio area since 1998.