What is a pulpotomy?
A pulpotomy is the process of partially removing and treating a baby tooth’s pulp, when it is deeply decayed. Pulp is the soft connective tissue underneath the crown of a tooth, which contains blood vessels and nerves. Once the superficial portion of the pulp has been properly removed and medicated, a stainless steel crown is then placed over the top of the crown, to protect the tooth until it is ready to exfoliate naturally.
A pulpotomy can also be referred to as ‘root canal for children’. This is commonly performed on children as baby teeth have larger pulp chambers so tooth decay can easily reach the pulp and cause an infection.
How do I know if my child needs a pulpotomy?
At Concord Dental Practice, we perform thorough examinations of your child’s teeth. Once all your child’s back teeth have erupted (normally at the age of 3-5 years), it is very important to have bitewing xrays taken to assess for decay in between the teeth. Visually, decay in between the teeth is very difficult to see, and if we rely solely on this examination, dental decay may be missed. Often, once decay has broken through the tooth and caused a cavity that can be visually seen, a simple filling will not be sufficient in treating the tooth.
On an x-ray, if decay can be seen in the second layer of their tooth (called dentine), a pulpotomy may be indicated as the bacteria may have started to cause irritation of the nerve tissue already. If such teeth are simply filled, there is a good chance that they may cause pain, abscess or become infected in the future.
Not every tooth that has been treated with a pulpotomy can be saved. Your child’s symptoms will also be assessed, as this will influence the outcome of the pulpotomy. If your child has already started to experience severe toothache, an extraction may be required, as this indicates that the infection has progressed too far into the nerve tissue.
The purpose of a pulpotomy is to SAVE your child’s tooth. Early loss of baby teeth will lead to future dental crowding of teeth and the need for braces for tooth straightening. Loss of space due to movement of adjacent teeth if a tooth is extracted too early can be prevented with the use of a space maintainer (please see blog “what is a space maintainer” for more information).
Is a pulpotomy always successful?
A pulpotomy will provide your child’s tooth with the best outcome; however, sometimes these may even fail and eventually require extraction. A space maintainer will then be required. Therefore, regular check ups at Concord Dental Practice are required to ensure that the treated tooth is still healthy, and that no new areas of decay appears elsewhere in your child's mouth.