When decay invades the interior of a child’s molar, it’s necessary to remove the decay to stop the tooth from developing an abscess. If this sounds familiar to an adult procedure known as a root canal, it is, but to a lesser degree. That’s why pulpotomies are often called “baby tooth root canals.” At Children 1st Dental, we use pulpotomies to keep from having to extract a baby molar. This has the advantages of keeping the tooth in place for spacing and it makes it easier for the child to chew on that side of the mouth.
What would my child need a pulpotomy?
You may wonder why we can’t simply fill the tooth with the decay. But if a cavity gets really close to, or even into, the pulp the bacteria will infect the tissue. This will usually cause a toothache, and if not addressed it will likely require the tooth to be extracted.
Once decay gets inside the tooth, it has access to the nerves, blood vessels, and pink connective tissue inside the tooth. This will create an infection in the pulp. In an adult tooth, at this point a root canal would be used to save the tooth. This involves basically cleaning out all of the pulp in the tooth, down through the root canals, disinfecting the now-hollow interior of the tooth, filling it with a rubbery material, and then placing a crown on the tooth.
Pulpotomy can save the day
Like a root canal, with a pulpotomy the goal is to keep the tooth in place. But, unlike a root canal, with the child’s tooth only the infected tissue inside the upper chamber of the tooth will be removed and the remainder, particularly the soft tissue going down into the root canals, will be saved. The procedure is very effective and very common.
How is a pulpotomy performed?
First, as with all of our procedures, our goal is to keep the child calm. We may start with a numbing agent on the gums to then allow for painless insertion of the numbing agent. We may use nitrous oxide to relax the child.
After the area is numb and the patient relaxed, we make an opening in the top of the molar in order to access the pulp chamber. Next we remove the decayed tissue from the pulp chamber. We don’t go down into the root canals, if possible. Now it’s time to sterilize the remaining pulp stumps. We do this by placing a cotton ball with formocresol on it into the tooth, and leaving it for a few minutes. When confident any remaining bacteria are eliminated, we place a medicated filling material into the tooth and let it harden. To make room for a crown, a portion of the top and each side of the tooth is shaved off. We then cement a stainless steel crown onto the tooth and the procedure is complete. Now the tooth will have the strength necessary for biting and chewing thanks to the crown.
A pulpotomy is a reliable way to save the baby molar, which will then hopefully remain in the mouth until it is naturally replaced by the permanent molar in time.
Are there risks with a pulpotomy?
A pulpotomy is very common and very safe. The pulp in the root canals could become infected if any bacteria weren’t removed, but this is rare. In those cases, the tooth would be extracted.
Recovery and aftercare
There isn’t any recovery or special aftercare necessary. The child’s mouth could be a little tender due to being open, but the procedure doesn’t involve much residual pain. Remember, the infected pulp was removed, and that is usually what was causing the tooth pain in the first place. Simple good home hygiene is all that’s needed going forward.
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