What is Pulp Therapy?

The “pulp” of a tooth cannot be seen with the naked eye. Pulp is found at the center of each tooth, and is comprised of nerves, tissue, and many blood vessels, which work to channel vital nutrients and oxygen.  There are several ways in which pulp can be damaged.  Most commonly in children, tooth decay or traumatic injury lead to painful pulp exposure and inflammation.

Pediatric pulp therapy is known by several other names, including: root canal, pulpotomy, pulpectomy, and nerve treatment.  The primary goal of pulp therapy is to treat, restore, and save the affected tooth.

Pediatric dentists perform pulp therapy on both primary (baby) teeth and permanent teeth.  Though primary teeth are eventually shed, they are needed for speech production, proper chewing, and to guide the proper alignment and spacing of permanent teeth.

What are the signs of pulp injury and infection?

Inflamed or damaged pulp can cause severe pain. Even though the source of the pain may not be visible, it will become apparent that the child requires immediate attention from a pediatric dentist.

Here are additional indicators to watch out for:

  1. Persistent unexplained pain.
  2. Pain experienced primarily at night.
  3. Sensitivity to hot and cold food or beverages.
  4. Swelling or redness around the affected tooth.
  5. Unanticipated looseness or movement of the affected tooth.

When should a child undergo pulp therapy?

Each case is distinct, and the pediatric dentist evaluates factors such as the child's age, tooth position, and overall health before deciding whether to extract the tooth or pursue pulp therapy to save it.

Here are some potential unfavorable outcomes associated with premature tooth extraction or tooth loss:

  1. Reduction in arch length.
  2. Insufficient space for permanent teeth to erupt when primary teeth are lost.
  3. Development of opposing teeth in a protruding or undesirable manner.
  4. Painful impaction of premolars.
  5. Adjacent teeth may shift to fill the gap.
  6. Abnormal tongue posture may occur

How is pulp therapy performed?

The pediatric dentist will visually examine and review X-rays of the affected areas. Treatment depends on the extent of pulp damage. Pulpotomy and pulpectomy are common procedures.

Pulpotomy: If only the pulp tip is affected, the dentist removes the damaged pulp, fills the gap with a therapeutic material, and places a crown to strengthen the tooth.

Pulpectomy: If the entire pulp, including root canals, is affected, the dentist removes it, cleans the canals, fills the area, and adds a crown for support.

Primary teeth may use reabsorbable fillings, while permanent teeth use non-reabsorbable fillings. Crowns can be natural-colored for aesthetic purposes

If you have questions or concerns about the pediatric pulp therapy procedure, please contact your pediatric dentist.

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