Pulpotomy & Pulpectomy
Ranging from cavities to bleeding gums, the problems associated with oral health can be fixed, thanks to the advent of modern medical procedures used by dentists. In cases where children have deep cavities, your dentist may suggest different solutions including getting a therapeutic pulpotomy or tooth pulpectomy.
For kids with baby teeth, expressing their discomfort using words may be difficult, so you may need to observe closely to note when your child is uncomfortable and needs a dentist. Routine visits to your dentists will help place you and your child stay ahead of big dental problems.
If your child’s dentist recommends a therapeutic pulpotomy or pulpectomy, here are some things you may need to know. Or you may have heard about pulpotomies and want to know how the pulpotomy procedure is.
So what then is a pulpotomy, who can get a pulpotomy and when should you get a pulpotomy? What is the difference in a therapeutic pulpotomy and a tooth pulpectomy?
What is a pulpotomy?
Simply put, a pulpotomy is a dental procedure used to remove the infected pulp of a tooth to stop it from decaying further. When the pulp in the crown of a tooth is infected, the pulp is excavated and filled while causing no damage to the root canal. This procedure is used mostly on children with baby teeth.
Translated literally, ‘pulpotomy’ means ‘remove the pulp’ or ‘cut the pulp’, but medically, it covers the whole procedure of removing the infected pulp, filling it, and replacing the crown.
So if you’re considering removing the whole baby tooth because the permanent tooth will grow eventually, this is wrong because the primary tooth is there to ensure that the permanent teeth grow in good alignment.
There are ways to discern if your child might need a pulpotomy. Your child may wince when hot, cold, or spicy food substances get into the mouth and a visit to the dentist and diagnosis will likely show signs of pulpitis. Cavities left untreated for too long can cause rotting of the pulp or inflammation of the pulp in that area. This inflammation is known as pulpitis.
The remedy to pulpitis is to undergo a pulpotomy as recommended by your dentist. As opposed to a pulpectomy, a pulpotomy is reserved for the treatment of infected pulp close to the crown of a tooth. The difference between a pulpotomy and a pulpectomy will be highlighted later in this article.
Baby teeth can be very delicate and if your child has suffered an impact on the teeth, causing damage or a crack, a pulpotomy may be needed.
A therapeutic pulpotomy is done on a deep decaying tooth with a large cavity. It is performed by trying as much as possible to preserve the pulp in the root and surface of the teeth.
We will list the pulpotomy steps below.
What happens during a pulpotomy procedure?
- Firstly, a topical anesthetic or cream will be administered to the area around the tooth to numb the area. Sedation is optional since pain will not be felt as the area around the tooth has been numbed.
- Next, if a thorough brushing of the teeth was not done at the beginning, the dentist will work to remove all visible dirt that can get into the pulp and cause an infection. In simpler terms, he cleans the area around the tooth properly.
- The enamel and the dentin are drilled to expose the pulp chamber during the pulpotomy procedure. Bleeding is expected if the pulp is still healthy, but if it is not, it may be filled with pus or it may be completely empty(no pulp or pus).
- After confirming that the pulp is healthy, the dentist proceeds to remove the coronal pulp and cotton swabs are used to slow down or stop the bleeding. The bleeding should stop between 3-5 minutes, but if it exceeds this, then the pulp in the root may be infected too and a complete extraction or a pulpectomy of the tooth will have to be carried out.
- When the bleeding ceases, the exposed pulp is treated with special medication and some dentists may use laser treatment as it is more effective.
- The pulp chamber is closed with a dental base, all decay is removed and a crown is placed.
Pulpotomy procedure video
What follows after getting a pulpotomy?
When the anesthetic wears off, a little pain may be experienced. In some cases, there may be swelling of the area around the tooth that was worked on. No need to panic as these conditions are normal and there may be medications given by your dentist to manage the pain and reduce the swelling.
You also want to follow the instructions on oral care given by your dentist. It may include instructions on the temperature of food and drinks, type of food and drinks that can be taken after the procedure, and if mouthwashes can be used. Adhere to these guidelines strictly to avoid future damages.
Difference between a pulpotomy and a pulpectomy
Pulpotomies and pulpectomies are both dental procedures that have similarities. This has a lot of people taking one for the other. Since they both involve procedures on the pulp of the teeth. The pulp is found both at the center and root of a tooth. The pulp is not visible to the eyes as they are surrounded by the crown of the tooth and dentin.
Pulpotomy and Pulpectomy treat pulp related issues using different procedures. Pulpotomy deals with the pulp at the center of the tooth, that is the coronal part. Pulpectomy removes all of the pulp and removing the root canal as well.
So while a pulpotomy removes the infected pulp, repairs the cavities, and saves the tooth from decaying further, a pulpectomy does the same but removes all the pulp, from the crown all the way to the root canal.
Are pulpotomies and pulpectomies safe?
A tooth pulpotomy and pulpectomy is safe and has a very low-risk rate. Although the procedure majors for children with baby teeth, children with permanent teeth, and even adults can undergo a pulpotomy or pulpectomy.
That sensitive tooth or decaying tooth can be restored. Your dentist will offer you the best solution after examining your teeth. In cases where the diagnosis is irreversible pulpitis, that is the tooth or teeth are completely damaged, a pulpectomy or complete extraction of the tooth may be recommended.
Pulpotomies and pulpectomies are very safe, the after-effects are temporal and medication and instructions will be given to help manage the pain and after-effects of the procedure. Remember to always carry out routine checks on your teeth by visiting your dentist regularly and sticking to a good oral hygiene routine.
Kelly Hancock, RDH
Kelly is a registered dental hygienist and oral health care provider. She is passionate about oral hygiene and encourages people to achieve optimal oral health. She has been working in the dental profession for 16 years and worked in many different roles in the dental industry. Kelly is currently a pediatric dental hygienist specializing in children’s dentistry. She is committed to helping others with their oral health care issues and helping others achieve a smile they love.