Pulpotomy isn’t one of those ‘obvious’ dental treatment terms where the name tells you what happens in the treatment. So in this article, Dr Panny Hou from Alderley Dental explains what’s involved in a pulpotomy procedure and why it’s done, the benefits and the side-effects for adults and children.
What is a pulpotomy?
A pulpotomy is where we remove the top part of the nerve. It’s a treatment that we mainly perform on children. This is because with little kids we often won’t do a complete root canal treatment, so a pulpotomy will remove just the part of the nerve that sits in the crown of the tooth. The crown of the tooth is the top half of the tooth, which means we don’t actually have to go down into the root canal.
Once the top of the nerve is cleaned out, we’ll put medication in there to stop the infection from continuing in the tooth, then fill the tooth with a filling. After the pulpotomy, the tooth looks just like a normal tooth again.
The Pulpotomy procedure in children
A pulpotomy is primarily performed on a child to prevent an infection getting into a nerve that’s dying off and gradually making its way down the root. We’re basically trying to hold that tooth safely in place for a bit longer for the child to use and save the space for the adult tooth.
- Root canal treatment
- Tooth removal or extraction
If it’s possible, nerve treatment through pulpotomy or a root canal treatment is preferred over tooth removal, so that the tooth remains in the child’s mouth, maintaining space and reducing the risk of crowding with adult teeth.
A root canal treatment is performed on children on rare occasions when the infection has spread further down the tooth and into the surrounding bone.
Why do dentists want to save children’s baby teeth?
Removing a baby tooth has negative implications for tooth and mouth development, so it’s something we avoid if possible. A baby tooth is like a sat nav or guidance system for the developing adult tooth coming in. By saving baby teeth until they’re meant to come out, we’re lessening the chance of braces or alignment problems in the future.
Another disadvantage of taking a child’s tooth out before it’s ready is that the adjoining baby teeth may begin to drift into this space. For example, if we take out the first baby molar, the second baby molar may sometimes drift forward, closing the space for the first adult molar to come into.
Pulpotomy in adults
A pulpotomy procedure is performed more rarely in adult patients, as root canal treatments are the standard treatment for infected teeth.
Pulpotomy in adults is used primarily in emergencies. If a patient comes in with a toothache because the infection has gone to the nerve of the tooth, they’ll usually be in a lot of pain. One option for the dentist to quickly relieve this pain is to go into the tooth, clean up some of the infected nerve tissue, then put some medication directly into the tooth. The aim is to quickly and effectively get the patient out of pain.
However, this kind of pulpotomy is not a permanent treatment and because the entire root canal system has not been disinfected – unlike a root canal treatment – the tooth may flare up again. Indeed, where possible, root canal treatment is commenced as soon as possible following this emergency procedure to prevent further progression of the infection.