rewrite this title When Is a Pulpotomy Necessary for Your Child’s Dental Health?

A pulpotomy is a dental procedure that treats infected teeth. It is usually performed on primary (baby) teeth in children, but it can also be used for adults with damaged dental pulp—the mass of connective tissue in the center of the tooth.

Pulpotomies are used if the tooth pulp becomes affected by caries (tooth decay or cavities), traumatic injury, or other causes. The procedure is performed by a general dentist or a pediatric dentist, a dentist who specializes in dental care for infants, children, adolescents, and people with special healthcare needs.

Pulpotomies treat pulpitis, or dental pulp inflammation, in primary teeth affected by caries or traumatic exposure. Pulpitis may present with normal pulp or the pulp may have limited reversible inflammation.

A dentist can perform a physical evaluation to determine if you have normal pulp or reversible pulpitis. Dental X-rays can determine whether inflammation has spread beyond the tooth apex (the tip of the tooth’s root) and rule out other conditions.

The physical examination may involve applying heat, cold, or a percussion test. A percussion test uses a small instrument to evaluate pain and inflammation. Additionally, an electric pulp tester may be used to determine if the pulp is vital or alive. If a small electrical charge is felt, then the pulp is vital.

Based on the results, a pulpotomy may be recommended to restore the primary tooth or teeth affected. While a pulpotomy is commonly performed on children, it can also be performed on young adults and adults.

There are two types of pulpotomy procedures—partial and full.

A successful partial pulpotomy should result in vital pulp, with continued root development and no physical signs of pain, swelling, or sensitivity. Follow-up X-rays should also show results such as no abnormal buildup of calcium on the root canal and no signs of periapical radiolucency (a hole in the bone caused by inflammation under the tooth’s root).

A full pulpotomy should preserve the life of the remaining pulp and prevent the breakdown of periradicular tissues or tissues surrounding the apex of the tooth). It should also prevent tooth loss, decay, and calcification of the root canal.

A pulpotomy is performed at a dentist’s office so comfortable clothing can be worn to the appointment. Ask about the cost of the procedure or if it’s covered by dental insurance, and pay attention to instructions for eating and drinking before the appointment.

To help children feel more comfortable during a pulpotomy, remind them that the procedure does not take long and that they should not feel any pain during treatment. However, local anesthesia is used to numb the area of the mouth being treated, so they may have some discomfort unless the dentist uses a numbing gel first.

Pulpotomy treatment varies depending on the cause of the affected area. The type of procedure—partial or full pulpotomy—also will determine the steps.

During a partial pulpotomy, the dentist removes 1-3 millimeters of pulpal tissues underneath the affected area. During a full pulpotomy, the dentist removes the entire coronal pulp, which is located in the tooth’s crown.

During the Procedure

A pulpotomy is performed in a dentist’s office. First, anesthesia is administered to numb the area that is being treated so there will be no pain or discomfort during the procedure. You can choose to use nitrous oxide. With this approach, the patient will be sedated (feel calm and relaxed) during the procedure.

Depending on the type of pulpotomy and the reason for needing one, the dentist will perform one of the following procedures:

Partial pulpotomy (for decay): The dentist removes 1-3 millimeters of the inflamed pulp (the soft tissue inside the tooth) near the problem area. Healthy pulp is covered with a protective material like calcium hydroxide or mineral trioxide aggregate (MTA). MTA is preferred as it promotes better healing. Finally, a sealing material is applied to prevent leaks and protect the tooth.Full pulpotomy (for advanced decay): The entire inflamed pulp in the tooth’s crown is removed. A material like MTA or tricalcium silicate is placed in the hollowed area to restore and protect the tooth. This is done mainly for immature permanent teeth, allowing the root to develop. It can also be a temporary solution until a root canal is done.Partial pulpotomy (for injury): The dentist removes 1-3 millimeters of damaged pulp near the injury site. Once the bleeding is under control, the area is covered with calcium hydroxide or MTA. A final sealing layer is added to protect against future infection.

This treatment helps save the tooth and promotes healing until more permanent solutions are applied.

After the Procedure

After a pulpotomy, the dentist will provide aftercare instructions. You may experience discomfort as the anesthesia wears off, but you can go home after treatment. Over-the-counter (OTC) pain medication or Advil (ibuprofen) helps relieve pain and swelling.

Eat soft foods 1-2 days after the procedure, such as soups and pureed fruits, to avoid irritating your mouth. Also avoid hard, sticky, or crunchy foods during this time. Your dentist may recommend follow-up treatment to monitor results, but it is not always necessary.

While a pulpotomy is generally a safe procedure, there are some risks. These include side effects such as:

Fever
Swelling of the throat, jaw, or face
Worsening or severe pain not relieved by pain medication
Trouble talking or swallowing
Heavy or worsening bleeding
Pus or other discharge from the affected site

If you or your child experience these side effects, schedule an urgent dental appointment or visit your nearest emergency room.

Using MTA in a partial pulpotomy for teeth affected by trauma may cause discoloration. Pulpotomies also weaken the tooth’s structure, which increases the risk of fractures. Follow your dentist’s aftercare instructions to prevent infection and avoid further damage to the tooth.

While pulpotomies are safe for children and adults, use caution if you have a bleeding disorder or are pregnant. You may be able to have this procedure even if you have a bleeding disorder or are pregnant, but it depends on several factors and considerations. Speak to your dentist about potential risks and precautions before making a decision.

Once a pulpotomy is completed, you may have a follow-up appointment to assess the results and to treat any side effects. However, this is not always necessary.

While the treatment takes one appointment, the tooth may need future treatment. To prevent damage and prolong future treatment, practice good oral hygiene (such as brushing your teeth at least twice daily) and eat low-sugar, nutritious foods to help prevent tooth decay and cavities.

A pulpotomy is a common dental procedure that treats the infected pulp of a tooth. Causes of a pulpotomy include caries and trauma to the tooth. A pulpotomy is a safe and effective procedure for both children and adults.

Side effects are rare but may include fever, swelling, intense pain, and heavy bleeding. See a dentist or healthcare provider if you or your child experience any side effects.

To maintain and prolong the results of a pulpotomy, practice good oral hygiene, eat nourishing, low-sugar foods, and see your dentist for regular check-ups.