Pulpotomy on baby tooth

By Alderwood Family Dentistry December 2, 2016

The dentist said your child needs a pulpotomy!

Many parents believe that baby teeth are not worth saving because the adult teeth will soon come in place.

In my practice I try to explain to those parents that the role of the baby teeth is vital to the development of their counterpart adult ones.

Most often parents are reluctant to do any treatment because of finances. When this is the case, I try to show them how the lack of treatment can cost more afterwards. For instance, the cost of orthodontics treatment that may be needed due to premature loss of teeth or the cost of more invasive treatments such as root canals or extraction of adult teeth due to damage caused by infection on the baby tooth.

The baby teeth are a small sample of what your adult teeth may look like. They serve as guidance for the adult ones, showing them their way out of the gum. Also, there are measurements that can be done to verify whether there is enough space for the adult teeth to come in.

When a baby tooth has an untreated cavity it can not only be painful to your child but it can become infected and cause several other health issues including abscesses. If untreated, an abscess has the potential to damage the adult tooth as well put in risk your child’s general health.

When the baby tooth becomes severe decayed one of the procedures that may be done to avoid pulling the tooth out is called pulpotomy. A pulpotomy is a partial root canal that can be done in the baby tooth to avoid losing the tooth before its time.

SSC after pulpotomy

Stainless Steel Crown placed after a pulpotomy procedure

When we do a pulpotomy we freeze the tooth and the gum, and place a rubber dam to protect it. Then we remove the cavity by drilling it out. Once the cavity is removed we use a round bur to take the nerve out as well. Following this first procedure we add some medicament to dry the inside of the tooth where the nerve was and to make sure that there will not be any bleeding from the tooth. Once the tooth is completely dry we place a filling material where the nerve was and restore the tooth using a stainless steel crown or a ‘strip crown’ to mold the composite in place.

A stainless steel crown is a metal cap that embraces the whole tooth, protecting it. It is cemented on the tooth. A strip crown it is a cap that is molded onto the tooth by using composite. Usually strip crowns are more indicate for anterior teeth since it can mimic natural tooth colour.

The following are some contraindications for pulpotomy: spontaneous pain, fistula or swelling, absent or profuse hemorrhage, mobility and/or tenderness.

Your dentist will be able to verify all these symptoms before indicating pulpotomy. If pulpotomy is not indicated for that tooth, a pulpectomy or extraction will be recommended. A pulpectomy is a complete root canal of a baby tooth.

If an extraction is recommended your dentist may recommend “space maintainers” to keep the space open for the adult tooth.

A health kid is a happy kid.




Author: Dr. Jonas Stefani, DDS. Principal dentist at Alderwood Family Dentistry – dr.stefani@afdentistry.ca



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