If your child has dental decay that spreads into the pulp cavity of a baby tooth, it can cause quite a lot of pain. A regular filling will not ease your child's discomfort because your dentist won't be able to remove all of the decay without damaging the nerve. In this case, a pulpotomy, sometimes called a pulpectomy, will be recommended. Here are the facts you need to know about this dental procedure.
What Does a Pulpotomy Entail?
First, your child's dentist will administer a local anesthetic to prevent pain during the procedure. In some cases, such as when a child is very young or not able to sit still in the dental chair, sedation will be used. This is something to discuss with the dentist before the appointment, if possible.
In most cases, a dental dam will be placed on the tooth. During the pulpotomy itself, the dentist will drill a small hole on the biting surface of the tooth so he or she can access the pulp cavity. Tiny instruments, called dental files and reamers, are used to remove the damaged nerve tissue. A slow-speed handpiece, which is a type of dental drill, might be used to widen the canals if the nerve tissue is difficult to access.
Once all of the nerve tissue and blood vessels are removed from the space, a medicated filling is placed in the pulp cavity and a permanent filling is placed over that. This will reduce the risk of the tooth becoming infected and will relieve residual pain.
What Happens After a Pulpotomy?
In most cases, your child will need to have a stainless steel (silver) crown placed over the baby tooth after a pulpotomy. This is because the tooth will become more brittle after the nerves and blood vessels are removed from the pulp cavity. The crown will protect the tooth from cracking.
The dentist might be able to place the crown right away if the procedure was planned in advance and your child is tolerating the procedure well. In many cases, you will need to make a second appointment to place the crown. This gives your child a break from sitting in the chair with his or her mouth open and allows time for the dental lab to fabricate the crown if the pulpotomy was not planned in advance.
After the crown is placed, it's important for you to help your child keep up with brushing and flossing the area. While the crown will help protect the tooth from further decay, bacteria can still get into the area between the crown and the gumline. Keeping the baby tooth intact will save space in your child's mouth for the permanent tooth that will grow in soon.
How Does a Pulpotomy Differ From a Root Canal?
Many dentists will describe a pulpotomy as the first part of root canal therapy. A full root canal treatment entails placing a permanent filling material, called gutta percha, into the nerve space. Because a baby tooth does not have closed nerve spaces and because the root will dissolve as the permanent tooth grows in, this part of the treatment is unnecessary. A pulpotomy takes much less time than full root canal therapy.
While the idea of a pulpotomy might be frightening to your child, his or her experience will be similar to having a regular filling done. Focus on how the procedure will relieve the toothache, and be sure to assure your child that they won't feel anything during the procedure. By staying positive, you can alleviate your child's stress and make it more likely that he or she will approach it without fear.
Talk with a pediatric dentists to get more information about a pulpotomy or similar procedures.