What is a Pulpotomy (in Primary Teeth)?

Every tooth—whether adult or baby (primary)—has a nerve running down the center of it. We often call this nerve tissue the “pulp,” and it reaches through the roots into the nerve and blood vessels below. The pulp is what keeps the tooth alive and helps perceive pain or temperature changes. Occasionally, parents will hear that their child needs a pulpotomy in primary teeth.

Understanding what a pulpotomy is and how it benefits your child can reduce their dental needs in the future, not to mention encourage healthy oral development.

What is a Pulpotomy?

A pulpotomy involves creating an opening at the top of your child’s primary tooth to access the nerve tissues inside. From there, the pulp is completely removed, and the inside of the tooth is medicated.

Normally a temporary crown is placed over each tooth after it is treated with a pulpotomy because the brittle tooth structure needs extra reinforcement for biting and chewing. These crowns are durable enough to last for the few years left that your child needs their tooth, but they aren’t permanent like the ceramic ones used on adults.

Why Does My Child Need a Pulpotomy?

Pulpotomies are often one of the last lines of defense for treating severe tooth pain and preventing premature tooth loss.

Your child may need a pulpotomy if they have

• An active dental abscess
• Extremely large decay inside of the tooth
• Severe pain coming from that tooth
• Recurring cavities around an existing, large dental filling

Ultimately Dr. Houri will order an X-ray of the tooth so that we can see in and around the entire tooth structure. If there is a visible cyst around the root of the tooth or deep decay extending into the nerve, a pulpotomy will most likely be prescribed.

Root Canal vs. Pulpotomy in Primary Teeth

Adults with abscessed teeth need root canals. But when it’s a baby tooth, our Vista pediatric dentist will recommend a pulpotomy.

What’s the difference?

A root canal involves permanently filling the inside of the tooth and nerve chambers. A pulpotomy (or as some people call it, “pulpectomy”) in primary teeth only involves removing the nerve and medicating the tooth, rather than “filling” the inside of it.

This different approach is necessary because the primary tooth will gradually shrink/resorb away as it’s replaced by the permanent tooth below it. If there were permanent root fillings like a root canal, the restoration would interfere with the eruption of the future permanent tooth.

Risks of Not Getting a Pulpotomy

When a child is only going to have their primary tooth for another month or so, it may be better to remove the tooth instead of getting a pulpotomy. But if the tooth is supposed to stay there for a couple more years, removing it could jeopardize their overall oral development. For example, premature tooth loss (from an extraction) could lead to the adjacent teeth tilting inward, impacting the adult tooth below.

By preserving your child’s primary tooth, Dr. Houri can help ensure healthy tooth eruption patterns and lower the need for orthodontic therapy in the future. Additionally, your child will be able to eat more comfortably and speak more clearly.

What to Expect

Dr. Houri performs several pulpotomies every week for children in pain or who have abscessed teeth. Using gentle techniques and numbing medication, your child won’t feel any different than they would getting a routine dental filling. We also have “happy gas” and “sleepy juice” to help children feel more relaxed, depending on their personality and comfort level.

By treating the tooth early, our Vista pediatric dentist can help your child break the cycle of tooth loss and avoid potential dental emergencies.

Pediatric Pulpotomy in Vista

Dr. Houri values your child’s oral and overall health, not to mention their comfort. If your child has an abscessed tooth or is at risk for premature tooth loss, ask how a pulpotomy (in Vista) can help. Contact All Smiles Children’s Dentistry today for a no-obligation exam and consultation. We’re happy to answer all of your questions!

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