When the nerve or pulp tissue of a primary or permanent tooth in children is infected, it needs to be treated to prevent a dental abscess (due to infection) and loss of the tooth. The two methods of treating infected dental nerve tissue are the pulpotomy and pulpectomy. The ultimate objective of these procedures is to save the tooth, so that it will maintain the integrity and function of the dental arch.
What is pulpotomy?
During a pulpotomy the infected part of the nerve is removed while the remaining healthy nerve is left behind. A sedative medication is placed inside the tooth to prevent sensitivity and to promote healing. A cap is then placed on the tooth.
What is pulpectomy? (Root Canal Treatment)
A pulpectomy is carried out by the total removal of the nerve, of the infected/ abscessed tooth. A cap is then placed on the tooth.
Why does my little child need pulp therapy/ root canal treatment? Isn’t it a treatment for adults?
When tooth decay (cavity) isn’t treated on time, it gets deeper and the infection reaches the nerve (pulp tissue). Sometimes the tooth may be asymptomatic (have no complaints) initially. The child will eventually have episodes of pain (often severe) and swelling.
Once the cavity affects the nerve, the tooth can either be saved with root canal treatment or needs to be extracted. Since milk teeth require to function in the mouth for many years, saving them with root canal treatment is always the treatment of choice. Sometimes the degree of infection is severe and condition of the tooth really bad. We may then need to extract the tooth and place a space maintainer.
What will the procedure involve?
All teeth requiring root canal treatment will need to be numbed first with a local anaesthetic. The infected pulp tissue (nerve) along with bacteria is then removed. The canals within the roots are treated with a disinfectant and filled with a medicated paste. The tooth is then restored with a filling and a stainless steel crown.
Will root canal treatment in milk teeth affect the permanent teeth?
Infection around the roots of the milk tooth can irritate the developing permanent tooth. Therefore treating an infected milk tooth will affect the permanent tooth positively, if at all!
There is no connection between the nerve (pulp tissue) of the milk tooth and that of the permanent tooth. They are separate entities.
Will the treatment be painful?
Your child will receive local anaesthesia in the tooth to be treated. This will numb the tooth and make treatment pain free.
Is a cap necessary after root canal treatment?
Teeth requiring root canal treatment, most often have very large cavities. This makes these teeth prone to fracture after treatment. The chances of the large filling chipping post treatment are also high.
To ensure success of treatment, we always insist on a stainless steel crown on all milk teeth that receive pulp therapy.
Will the tooth fall naturally?
Yes. Teeth treated with pulpotomy/ root canal treatment usually shed naturally along with their cap. Rarely may they need to be extracted, years later, when the permanent is ready to erupt.