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Pulpotomies (baby tooth nerve treatment)

The two common forms of pulp therapy in children’s teeth are a pulpotomy and a pulpectomy.
The pulp of the tooth is the hollow inner core of the tooth. The pulp contains nerves, blood vessels, connective tissue, and reparative cells. The purpose of pulp therapy in pediatric dentistry is to maintain the integrity of the affected tooth, so that your child’s tooth is not lost, until his/her permanent tooth is ready to erupt. Dental caries (cavities) and traumatic injury are the two main reasons for your child’s tooth to require pulp therapy. Pulp therapy is often referred to as a “nerve treatment,” “baby or children’s root canal,” “pulpotomy,” or “pulpectomy.”

A pulpotomy is a dental procedure that is performed when the decay in a child’s tooth reaches into the pulp (nerve) tissue. The infected part of the nerve tissue within the crown portion of the tooth is removed to prevent further inflammation and spread of disease (caries). Next, a sedative material is placed within the tooth to prevent bacterial growth and to calm the remaining nerve tissue.

After the pulpotomy is finished, your child’s tooth is restored with a stainless steel crown (SSC) on the back molar teeth to re-establish normal chewing function and to continue to hold the space until the permanent tooth can take its place. On the upper front teeth, either a regular stainless steel crown or a white esthetic stainless steel crown can be placed. This is performed in one visit and causes no more discomfort than placing a routine filling.

A pulpectomy is required when the entire pulp is involved. During this treatment, the diseased pulp tissue is completely removed from both the crown and the roots. The canals are cleansed, disinfected, and in the case of primary teeth filled with a resorbable material. Then a final restoration is placed which would be the same choices as for a pulpotomy on a primary tooth. A permanent tooth would be filled with a non-resorbing material and either a temporary stainless steel crown or an adult ceramic, porcelain, or gold permanent crown would by placed.