Extensive decay and trauma can cause infections inside the core of a child’s teeth. This core, called the pulp, needs to be cleaned out to prevent an infection from spreading to other teeth or bones. Pulp therapy removes the damaged pulp and replaces it with an antibacterial filler to prevent further infection.
Baby Teeth and Dental Health
Your child’s primary (baby) teeth are very important to their overall oral health, despite the fact that the teeth will be replaced before their teen years. If one of your child’s baby teeth is subjected to heavy decay, or has been severely damaged by trauma, it is possible that it could spread infection to the surrounding teeth and bone. Decay and trauma can damage the pulp of the tooth, which is located in the core of a tooth.
Repairing Baby Teeth
The pulp contains tissue, nerves, blood cells, and restorative cells for repairing teeth and keeping them healthy from the inside. If this part of the tooth becomes damaged, it can get infected. The resulting infection can spread to other teeth, including future adult teeth, or possibly even the jaw, which can bring a host of other problems.
Pulpotomies and pulpectomies address this issue by either removing decayed pulp from the crown and pulp chamber (pulpotomy) or removing all of the pulp from the crown down to the roots (pulpectomy). After the pulp is removed, an antibacterial agent is placed inside the emptied pulp chamber and root canal. This agent helps to calm the nerves and irritated tissue, as well as helps prevent bacterial growth from causing more infections. Lastly, a crown, usually stainless steel, is placed atop the tooth.
When damage or decay causes an infection of the pulp inside the crown of a tooth, a pulpotomy may be required to remove this damaged pulp. Once the damaged pulp is removed, it is replaced with an antibacterial filler to prevent further infection.
Risk of Infection and Causes
When decay or dental trauma is located in the crown of a tooth, a pulpotomy may be necessary to remove the damaged pulp and prevent the spread of infection. The pulp is a collection of nerves, tissue, blood vessels, and restorative cells in the core of teeth. If the pulp gets damaged from decay or trauma, it can become inflamed, painful, and possibly infected. A tooth that has become infected can spread this infection to other teeth, including future adult teeth, as well as to the bones of the jaw.
The primary causes of pulp damage include:
- Deep cavities
- Damage to a tooth from an injury or impact
- Spreading infection
Testing and Procedure
Using x-ray imaging to determine the extent of decay or damage inside a tooth, we can determine whether a pulpotomy or a more in-depth pulpectomy will be required. Pulpotomies are best used when the damage is only to the pulp within the crown of a tooth. After imaging the mouth and affected teeth, we use a local anesthetic to numb the area surrounding the affected teeth. This anesthetic will reduce or eliminate any discomfort from drilling and filling the tooth. If necessary, we can also administer nitrous oxide, commonly referred to as laughing gas, to help keep the child calm and relaxed.
We remove some of the tooth around the visible cavity or break, and begin removing the pulp from the crown of the tooth. All of the infected material will be removed, while still leaving the healthy roots of the teeth intact. An antibacterial filler will be used to fill the cavity and prevent further infections from occurring in that tooth. Lastly, a crown will be placed over the core of the tooth to protect it and maintain functionality for chewing, drinking, and speaking.
A pulpectomy is a more involved procedure than a pulpotomy. During a pulpectomy, we remove all of the pulp from the pulp chamber and the roots of the tooth. The remaining cavity is then filled with an antibacterial resin to prevent further infections.
Extensive Decay and Infection
In more severe cases of decay or dental trauma, the damage may reach beyond the pulp cavity down through the root canals of the teeth. This is a more advanced condition that leaves decay and inflamed tissue in the pulp cavity, which is at the core of the tooth, as well as in the roots, which ferry nutrients, blood, and nerve signals to and from the teeth. If the damage gets to this point, the pulp needs to be removed in order to prevent the spread of infection.
Testing and Treatment
By using x-rays, we can see inside teeth we suspect have extensive decay. The x-rays will show how extensive the decay is, and we can determine how much of the dental pulp needs to be removed. Before conducting the procedure, we use a local anesthetic to reduce or eliminate discomfort around the child’s tooth. Laughing gas can also be used to help keep your child calm. Once numbed, we remove the dental pulp from inside the crown of the tooth all the way down through the root canals. We remove all of the tissue to ensure no infected tissue remains, which could still spread to other teeth or bones.
After removing all of the infected dental pulp, the entire cavity is cleaned and disinfected. We then use an antibacterial composite resin filler to fill in the root canals and pulp chamber. The resin will protect the inside of the tooth from bacteria as well as prevent further infection. After filling the tooth, a protective crown is applied so that your child will be able to eat, drink, and speak normally.
Crowns are placed on top of teeth that have had a pulpotomy or pulpectomy performed. Stainless steel crowns are a perfect temporary solution for protecting baby teeth before they fall out as the child gets older.
Primary (baby) teeth play an important role in oral health. Not only do they allow a child to eat, drink, and speak normally, they also maintain spacing for permanent (adult) teeth to come in later in life. When a tooth falls out on its own, the adult tooth erupts from the gums to take its place. It’s important to keep existing baby teeth intact until this process occurs, as removing a tooth due to decay can cause adult teeth to erupt out of place, which may in turn require more dental procedures be performed.
When a pulpotomy or pulpectomy are performed, we like to keep as much of the original tooth as possible, even though it’s likely within a short amount of time it will fall out on its own. After removing diseased and infected dental pulp from the pulp cavity and roots, we use a stainless steel crown to protect the core of the tooth, as well as restore normal function to speech, eating, and drinking.
Types of Dental Crowns
Stainless steel crowns are fairly inexpensive, and they are a great temporary solution for protecting baby teeth until the permanent teeth take their place. Stainless steel is a clean surface that resists bacterial growth, making it an ideal option for crowns. By resisting bacterial growth on the outside of the tooth, as well as using an antibacterial filler in the core, we can help prevent the possibility of bacteria causing future infections on an afflicted tooth before it falls out on its own.
Unlike the crowns used to cap adult teeth after a root canal, stainless steel crowns are premade and can be prepared and fitted in the same visit, rather than two visits.