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What is a pulpotomy procedure and why may your child need one?

A pulpotomy procedure usually takes place in an effort to restore a tooth where bacteria from decay has reached the nerve tissue. In some cases when a tooth has suffered trauma the nerve tissue and blood vessels (usually called the pulp) can become exposed.

Whilst baby teeth do eventually fall out, they are important to maintain until the right age. This is because baby teeth are the caretakers for the space where adult teeth will eventually grow, so it is important to ensure they remain healthy. 

A pulpotomy procedure is the best option to keep your child’s tooth pain free and healthy. 

 

WHY WOULD YOUR CHILD NEED A PULPOTOMY PROCEDURE? 

If your child complains of pain when chewing foods or when eating cold, hot or sweet things, this could be a sign of inflammation of the pulp tissue also called pulpitis. This can be from bacteria in untreated cavities

At your routine dental visit your dentist will assess any teeth when examining them or by using radiographs (x-rays) for early cavities which when left untreated could lead to pulpitis, pain and extensive treatment.

An untreated cavity can destroy the outer layer of the tooth, and then affect the soft pulp inside your child’s tooth. This pulp is full of nerve tissue and blood vessels, so an infected tooth can become painful. 

Teeth can also become infected from oral trauma. If your child falls and breaks or cracks a tooth, oral bacteria can get inside the tooth and cause an infection. So following a dental injury it is important to get assessed by your dentist.

If left untreated, the bacteria eventually overcome or kill the nerve tissue and cause inflammation that is irreversible.

 

WHAT IS A PULPOTOMY PROCEDURE? 

A pulpotomy is a procedure that is performed to restore a child’s infected baby (primary) teeth. 

Firstly, an examination will be conducted to determine how severe the infection is. If the pulpitis has affected the pulp in the crown, or if the removal of the decay will expose the pulp, then a pulpotomy procedure will be carried out. 

A pulpotomy procedure involves the paediatric dentist opening up your child’s tooth and removing the infected pulp from the crown (the upper part of the tooth). 

The pulp is usually treated with a special medication that helps protect the pulp from infection. After this, your child’s tooth will be protected with a filling or a crown (that may be of stainless steel or zirconia), and the procedure is complete. 

 

WHAT IS THE DIFFERENCE BETWEEN A PULPOTOMY AND A PULPECTOMY / ROOT CANAL? 

A pulpectomy procedure is often referred to as a “baby root canal” and while it has some similarities to an adult root canal, there are also some key differences. 

If your child was to undergo a pulpectomy or root canal then all of the pulp within your child’s tooth (including the roots) would be removed and replaced with medication.

A pulpotomy’s aim is to preserve the healthy pulp tissue whereas a pulpectomy removes the pulp all together. A pulpectomy would only be performed on your child if it is discovered that they have irreversible pulpitis. 

 

WHY ISN’T MY CHILD’S AFFECTED TOOTH REMOVED INSTEAD? 

Here at Macarthur Paediatric Dentistry we do everything we can to save our patient’s tiny teeth. If your child’s tooth is beyond repair with a filling or typical dental restoration, we may advise a tooth extraction, but this is always a last resort. 

The reason why tooth removal is an absolute last resort is because primary teeth help ensure that the permanent teeth will have enough space to grow when they come through. 

 

CAN A PULPOTOMY PROCEDURE BE DONE IN THE CLINIC OR WILL MY CHILD NEED TO GO TO HOSPITAL? 

Many children can undergo this procedure in the chair with laughing gas. Others may require a visit to the hospital to have it completed under a short sleep or general anaesthesia.

This depends on the individual child. However this is usually assessed at your initial consultation where we can discuss the options for treatment.

 

WHAT PRECAUTIONS SHOULD MY CHILD TAKE AFTER HAVING A PULPOTOMY PROCEDURE? 

Pulpotomies are complex procedures but also very common. Most children do not need any pain relief and recover quite well. Some children may need paracetamol. The crown placed over the pulpotomy can feel foreign and cause some discomfort in the first 24 hours following the procedure.

 

REGULAR VISITS TO THE DENTIST CAN PREVENT THE NEED FOR A PULPOTOMY PROCEDURE

If a child’s cavity is picked up early enough, complex procedures can be avoided. Prevention is always the best plan when it comes to your child’s teeth and gum health. 

By booking regular visits to see one of our paediatric dentists or oral health therapists we can ensure we catch any signs of infection before it develops into a problem. 

If your child is overdue for their next appointment give us a call on (02) 9188-0202 or book online here

This article is intended to promote understanding of and knowledge about general oral health topics and to help begin the conversation with your children’s dentist. It should not be used as a substitute for professional advice, diagnosis or treatment. Always seek the advice of your health care professional prior to incorporating this as part of your child’s diet or health regimen.

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