What Is Pulpotomy?
If your child complains of tooth pain, it could stem from tooth decay or untreated cavities. In paediatric dentistry, a common remedy for such ailments is a procedure known as a pulpotomy, which some might casually term a “baby root canal.” It’s vital to understand that a pulpotomy and a traditional root canal are not the same.
A Pulpotomy focuses mainly on primary or baby teeth—the first set of teeth that children develop. This process involves removing part of the tooth’s pulp, specifically the inflamed pulp from the crown area, referred to as the coronal pulp. It differs from treatments usually applied to permanent or adult teeth. The primary objective of a pulpotomy is to maintain the tooth’s function and ensure the health of your child’s teeth by addressing the infection. Our Dentists in South Perth carry out Pulpotomies to preserve the health of baby teeth until the adult teeth emerge.
What is Dental Pulp?
Pulp is the softest, innermost part of our teeth, found within the pulp chamber. Think of it as the heart of the tooth structure. It’s filled with blood vessels, nerves, and connective tissues. These components nourish the live tooth and provide sensation. When something hot or cold touches your tooth, the pulp senses it.
Understanding Pulpitis
When the tooth pulp, the vital core of a tooth, becomes inflamed, this condition is known as pulpitis. This inflammation can manifest in the coronal (crown) part of the tooth, the root, or both. Pulpitis is one of the culprits behind the dreaded toothache, and the discomfort can be significant, especially if the inflamed or infected pulp goes untreated.
Reasons for Pulpitis to Occur
Pulpitis can be due to a variety of causes. The pulp, safely nestled beneath the tooth’s crown, is protected by layers like enamel and dentin. But these shields sometimes weaken or crack.
Here’s how pulpitis can arise:
Dental Caries or Tooth Decay: Tooth decay or cavities can progressively erode the protective barriers, making the pulp vulnerable.
Tooth Injury: Whether it’s due to trauma resulting in a fractured or cracked tooth, any form of damage can expose the pulp.
Dental Procedures: Sometimes, a dental procedure may unintentionally affect the tooth, especially if it is deep or extensive.
Bruxism: Clenching or grinding of teeth, known as bruxism, can wear down the enamel over time, compromising the tooth’s defence.
Types of Pulpitis
Pulpitis can be categorised into two main types based on its severity and potential for recovery:
Reversible Pulpitis: This is a milder form where the pulp is inflamed but remains vital. While the pulp in this state will react to stimuli like cold, heat, or sweets, the key characteristic is that the pain is transient. Once the stimulus is removed, the pain quickly subsides. The underlying cause, often a cavity or decay, can be addressed, and the pulp can return to a healthy state.
Irreversible Pulpitis: This more severe condition indicates that the pulp is no longer healthy due to persistent inflammation. Spontaneous pain can occur and linger even after removing the stimulus. In such cases, the damage to the pulp is extensive, making recovery impractical. The dentist removes the infected pulp during a root canal procedure.
Pulpotomy: Paediatric Dentistry Solution
A pulpotomy is a dental procedure usually done to treat primary teeth affected by tooth decay. According to Dr. Ellie Nadian, a Brisbane Paediatric Dentist, the primary goal is to preserve the vitality of the remaining pulp, saving the child’s tooth from a tooth extraction. By preserving the primary tooth for as long as it’s naturally intended to stay in the mouth, a pulpotomy can help maintain spacing for the permanent teeth and support proper jaw and dental arch growth.
Pulpotomy and Pulpectomy: The Differences
Pulpotomy and Pulpectomy are two procedures aimed at treating the tooth’s pulp. While both procedures involve the pulp, they differ in their approach and the extent to which the pulp is treated.
Pulpotomy
A pulpotomy is the surgical removal of the coronal portion of the pulp, leaving the pulp in the roots intact. This procedure is primarily recommended for child’s teeth (baby teeth) with extensive decay but where the root pulp remains unaffected or for cases where the pulp exposure is deemed reversible.
The affected pulp tissue in the crown of the tooth is removed, followed by the placement of a therapeutic dressing to maintain the vitality of the remaining pulp and prevent bacterial contamination. The damaged tooth is then restored, often with stainless steel crowns.
Pulpectomy
A pulpectomy procedure involves completely removing all the pulp tissue from the crown and the tooth’s root canals. This procedure is recommended when the entire pulp, including the root canals, is irreversibly inflamed or necrotic. It is typically the first step in a full root canal treatment. All pulp tissue is meticulously removed after accessing the pulp chamber and root canals.
The canals are then cleaned, shaped, disinfected, and filled with a biocompatible material to prevent future bacterial invasion. The tooth is subsequently sealed, typically with a filling or a stainless steel crown.
Pulpotomy vs. Root Canal Treatment
Pulpotomy and Root Canal Treatment (RCT) are both dental interventions that treat ailments of the pulp, but they differ in scope and application. In a pulpotomy, only the damaged segment of the pulp in the tooth’s crown is extracted, ensuring the root’s pulp remains undisturbed.
It’s often the preferred choice for baby teeth when the damage is confined to the crown’s pulp, aiming to preserve the root pulp’s vitality.
On the other hand, a root canal is a more extensive procedure that eradicates the entire pulp from both the crown and the entire root canal system of the tooth. This treatment becomes necessary when there’s irreversible inflammation or necrosis in the whole pulp, whether due to a deep cavity, trauma, or other factors.
Post RCT, the cleaned canals are filled and sealed to prevent future infections, while after a pulpotomy, a crown is often placed to protect the tooth.
The choice between pulpotomy and RCT is guided by the extent of pulp damage and the tooth’s overall health.
What Happens During a Pulpotomy Procedure?
Preparation: The dentist will first ensure you’re comfortable in the dental chair. They’ll place a protective sheet (often called a rubber dam) around the tooth to keep it clean and dry during the procedure.
Numbing the Area: A local anaesthetic will be applied to numb the tooth and surrounding area so you won’t feel any pain during the procedure.
Accessing the Pulp: The paediatric dentist will drill a small opening in the top of the tooth to access the damaged or decayed pulp inside.
Removing Affected Pulp: Only the top portion of the pulp, which is in the tooth’s crown, is gently removed. The pulp in the roots is left intact.
Medicating the Area: After removing the affected pulp, the dentist will apply a special medication. It helps to soothe the remaining pulp and prevent any infection.
Sealing the Tooth: The opening made earlier is sealed, typically using a dental filling.
Final Restoration: Often, especially for back teeth, the dentist will recommend placing a crown on the tooth. This protective cap ensures the tooth remains strong and prevents future breakages.
Aftercare: You’ll be given instructions on how to care for the tooth post-procedure. It may include avoiding certain foods for a few days and maintaining good oral hygiene.
Aftercare Following a Pulpotomy
Immediate Aftercare: Avoid eating or drinking until numbness subsides to prevent accidental biting.
Dental Hygiene: Regular brushing and flossing to maintain the health of the treated tooth and surrounding teeth.
Avoiding Hard Foods: Staying away from hard or sticky foods for a few days to prevent damage to the restoration.
Regular Check-ups: Visiting the dentist regularly to ensure the tooth is healing properly and to check for any complications.
Potential Symptoms: Mild discomfort or sensitivity may be experienced; however, severe pain, swelling, or prolonged sensitivity should be reported to the dentist immediately.
Smile Brighter with Acts Dental
Unlock your best dental health with Acts Dental. Situated in Perth, we prioritise your smile and wellness and take pride in being a Bupa-preferred provider, Medibank-preferred provider, HBF-preferred provider, HCF-preferred provider, and Nib-preferred provider dentist in Perth.
Don’t wait. Take a step towards a healthier, brighter smile. Book your appointment now by calling (08) 9474 5083 and embrace exceptional dental care today! Did you know you can also book online?