PULPOTOMY
​WHAT IS PULPOTOMY?
A pulpotomy is a dental procedure in which the pulp of the tooth in the crown (the crown is the part of the tooth that is visible) is removed and the pulp in the root canal is left intact. It is performed on baby and primary teeth (on children) and is used to treat tooth decay that has extended to the pulp. Pulpotomies are generally performed on baby teeth, but they can also be successfully performed on permanent teeth, too.
A pulpotomy should not be mixed up with a pulpectomy. The latter is performed when your child’s tooth decay has extended past the pulp in the crown to the pulp in the root of the tooth. If it is discovered that your child has irreversible pulpitis caused by tooth decay—where the pulp in the tooth is severely damaged—then a pulpotomy will not be performed. Instead, your child will have to undergo a pulpectomy or tooth extraction.
WHEN WILL A PULPOTOMY BE NEEDED?
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Each tooth have a soft core called a dental pulp. The pulp extends from the crown - the visible part of the tooth - to the tip of the tooth's root in the jawbone. The pulp contains nerves, blood vessels, and connective tissues. When a tooth is cracked or has a deep cavity, bacteria can enter the pulp. Left untreated, bacteria and decaying material will cause a serious infection or a tooth abscess, leading to pulp death, bone loss, and loss of the tooth itself.
If your child complains of pain when cold, hot, or sweet things touch their tooth or teeth, it may mean that they have pulpitis. Pulpitis is the inflammation of the pulp and its main cause is untreated cavities. This tooth sensitivity is often the first sign that your child may have caries.
The dentist will recommend that your child undergo a pulpotomy if, upon dental exam, it is discovered that your child has tooth decay which has affected the pulp in the crown. It is also done when the tooth decay is so close to the pulp in the crown that removing the decay will expose the pulp.
THE PROCESS​
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A pulpotomy is usually done by an endodontist or a general dentist. The pulpotomy treatment can take anywhere from 30 to 45 minutes, and in some cases, slightly longer.
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X-rays are taken to check the extent of the tooth damage.
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A local anesthetic will be injected to help control the pain. Alternatively, your child may be sedated. The option chosen is usually up to the discretion of the doctor.
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The dentist will single out the tooth to be treated and remove any tooth decay on or around the teeth to prevent contamination of the pulp.
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The pulp chamber will then be opened by drilling through the enamel and the dentin.
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Once the roof of the pulp is drilled through, it will bleed. This shows that the pulp is still healthy. If the pulp chamber is filled with pus or it’s empty and dry, then the dentist cannot continue with the pulpotomy. They must then either perform a pulpectomy or tooth extraction.
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The coronal pulp will then be removed.
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Wet cotton swabs or pellets will be used to stop the bleeding and clean the area. Ideally, this bleeding should stop within a minute or two, or tops five.
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Once the bleeding stops, the radicular pulp is treated and covered with special medication.
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Your child may experience some pain and/or swelling after the procedure. The doctor will likely prescribe pain medication to help with this.
