Each of our teeth has a center called pulp. This pulp contains nerves, tissues and numerous blood vessels that transport oxygen and nutrients to the tooth. The tooth pulp, however, despite being protected by the tooth enamel, still gets damaged because of tooth decay, infection, or injury. Since the tooth pulp contains the nerves and blood vessels, when it gets infected or inflamed, it can cause severe pain and discomfort. Hence, the need for pulp therapy. Pulp therapy is more known as a root canal, but it is also called dental nerve treatment, or pulpotomy and pulpectomy. Pulp therapy is needed to treat, save and restore the particularly painful tooth. For pediatric dentistry, pulp therapy is performed for both baby and permanent teeth.
How do I Know If My Child Needs Pulp Therapy?
Having an infected or inflamed tooth pulp is indeed the worst toothache, it is very painful. More so to a child. Your child may complain of constant tooth pain. You may only see some swelling or redness around the affected tooth but it will still be hard to pinpoint since the pulp is not visible the naked eye when looking through the mouth. He or she may also be very sensitive to both warm and cool food temperatures. When your child experiences any of these, it is imperative that as a parent, you will promptly bring your child to a pediatric dentist.
At the clinic, your child’s dentist may take a dental x-ray and it may show a deep and huge tooth decay. Based on the x-ray result and depending on the extent and location of the pulp damage, the pediatric dentist will then recommend the kind of treatment that needs to be done to repair the tooth after the tooth decay is addressed. The pediatric dentist will most likely recommend either a pulpotomy and a pulpectomy procedure to treat your child’s dental problem. In less severe cases, there is also another approach to treat an infected or inflamed nerve where the pulp chamber or the upper portion of the nerve is not removed. As an alternative, the dentist will put a medication that is placed on top of the pulp tip to lessen the inflammation, prevent the progression of the tooth decay, and ultimately promote healing.
What is Pulpotomy?
A pulpotomy is the recommended pulp therapy if the infected tooth’s problem is isolated in the pulp tip. In effect, pulpotomy will be performed if the pulp root remains unaffected by injury or decay. Your child’s dentist will remove the pulp chamber above the area where the nerve extends into the root or roots of the affected tooth. Generally, medication is also applied to the base of the chamber to keep the healthy nerve and prevent any further infection. This simply means that the healthy part of the tooth will be left alone and the pediatric dentist will only remove the affected pulp and surrounding tooth decay. After the treatment, it will result in a gap that will be filled with a bio-compatible, healing material that will prevent any more infection while soothing the pulp root. Usually, a crown is placed on the tooth after treatment to help strengthen the tooth structure and reduce any possible future fracture to the tooth. Pulpotomy can be done as a standalone therapy on both primary and permanent teeth. It can also be the first stage in a full pulp or root canal therapy. Normally, a primary molar will have a stainless steel crown placed while a front tooth may receive a form of composite filling as its restoration.
What is Pulpectomy?
Pulpectomy will be performed if the tooth has severe decay or trauma, so much so that the entire tooth pulp is affected. During the treatment, your child’s dentist will need to take away the pulp of the tooth and clean the root canals. The dentist will then need to fill the hollow area with the bio-compatible, healing material. This process will most likely require a few visits to the dentist to complete. Just like in pulpotomy, the last step is the crown placement to support and strengthen the tooth. The crown can be made stainless steel, porcelain or natural-colored crown.
Severe tooth decay can be a very painful experience for your child. That is why as your kids’ dentists, we encourage you and your child to keep a healthy, regular oral care routine. As we always say, prevention is better than cure.
Pulp Therapy for Primary and Immature Permanent Teeth, American Academy of Pediatric Dentistry (https://www.aapd.org/globalassets/media/policies_guidelines/bp_pulptherapy.pdf)
Pulpotomy in Primary Teeth, Colgate (https://www.colgate.com/en-us/oral-health/life-stages/infant-kids/pulpotomy-in-primary-teeth-)
What is A Pulpectomy? Colgate (https://www.colgate.com/en-us/oral-health/life-stages/infant-kids/what-is-a-pulpectomy-0117)