What is a Pulpotomy and Why does my child need one?
I am sure most parents feel confused when they hear the word “pulpotomy” and then feel fearful when this term is followed by the explanation of “your child needs a baby root canal”. There is something about the words “root canal” that seem to spark fear and anxiety into all of our brains and can cause us to take pause. So let me explain what a pulpotomy is, how it is vastly different from an adult tooth root canal, and why we do it. The term “baby root canal” is commonly used to provide an easier understanding of what is being done, but the term is not an accurate description of the process of what we do for your child. The sensations your child will feel during this process are not much different than during a traditional filling. The crown process will include some pressure sensations, but the actual pulpotomy does not provide any difference in sensation during or after the procedure.
What is a pulpotomy?
Simply put, a pulpotomy is the removal of pulp, or “nerve tissue” typically from a baby tooth. The part of the nerve tissue that is removed is the part that is on the crown of the tooth only. Meaning, this is only the part that is impacted by the cavity, the part that you can see in the child’s mouth. Any healthy nerve tissue in the roots of the tooth is left behind. This tissue is covered by a medicament or medication such as MTA, and then the tooth is protected with a crown. This prevents the tooth from breaking. This procedure is necessary if there is cavity into the nerve of the tooth to avoid tooth removal. It cannot be completed on teeth that are abscessed or otherwise have unhealthy nerve tissue.
Your doctor may show you an x-ray similar to this one on the left. The dark areas of the tooth that are outlined in black are the areas with cavity. When a cavity is close to the nerve like the tooth on the right, the dentist may plan it for a pulpotomy. He or she will remove the cavity, and if the decay exposes the pulp will remove the portion of the pulp outlined in red. They will then put the medication down over the pulp present in the roots, and restore the tooth with a crown to protect it.
Your doctor may show you an x-ray similar to this one on the left. The dark areas of the tooth that are outlined in black are the areas with cavity. When a cavity is close to the nerve like the tooth on the right, the dentist may plan it for a pulpotomy. He or she will remove the cavity, and if the decay exposes the pulp will remove the portion of the pulp outlined in red. They will then put the medication down over the pulp present in the roots, and restore the tooth with a crown to protect it.
The portion outlined in red shows the part of the nerve of the baby tooth that will be removed during the pulpotomy. The other healthy parts of the pulp, or nerve tissue, will be left intact with medication placed over top. This allows for the permanent tooth below to be protected.
Your doctor may show you an x-ray similar to this one on the left. The dark areas of the tooth that are outlined in black are the areas with cavity. When a cavity is close to the nerve like the tooth on the right, the dentist may plan it for a pulpotomy. He or she will remove the cavity, and if the decay exposes the pulp will remove the portion of the pulp outlined in red. They will then put the medication down over the pulp present in the roots, and restore the tooth with a crown to protect it.
How is this different from a root canal?
A root canal is completed when the nerve of the tooth is removed and the space where the infected nerve was present is cleaned and shaped for placement of a biocompatible material into the nerve space. There is no remaining nerve tissue in the tooth after completion of a root canal, however this procedure allows for the tooth to be saved and avoids extraction. A root canal is a procedure completed on adult teeth. There is a similar procedure called a pulpectomy that can be completed on baby teeth, but we recommend speaking with your pediatric dentist if this procedure is recommended to you.
