When a cavity runs deep, it can reach the soft center of the tooth where the nerve lives. Pulp therapy treats that inner tissue so your child’s tooth can stay in place instead of being removed. It’s a routine procedure for a pediatric dentist in San Antonio, and in many cases it’s finished in the same visit as the crown that protects the tooth afterward.
What is pulp therapy?
Every tooth has a hard outer shell and a soft core called the pulp, which holds the tooth’s nerves and blood vessels. When decay or an injury reaches the pulp, it can become inflamed or infected. Your child might complain of a toothache, sensitivity to hot or cold, or discomfort when chewing, though sometimes there are no signs at all until we see it on an X-ray.
The most common type of pulp therapy in baby teeth is a pulpotomy, sometimes called a “baby root canal.” Your child’s dentist removes the affected pulp from the top part of the tooth, leaves the healthy pulp in the roots and places a medicated filling to calm and seal the area. The goal is to keep the tooth healthy and functioning until it’s ready to fall out naturally.
Why save a baby tooth?
Baby teeth guide permanent teeth into place. A molar lost years too early can let neighboring teeth tip into the gap, which can crowd the adult tooth and affect your child’s bite. Keeping the tooth also lets your child chew comfortably and speak normally. The American Academy of Pediatric Dentistry (AAPD) includes pulp therapy among its recommended treatments for preserving primary teeth when the tooth can be restored.
If an infection has spread too far, or there isn’t enough healthy tooth to restore, your child’s dentist will talk with you about Tooth Extractions instead, often followed by one of our Space Maintainers to hold the gap open.
What to expect during treatment
- Imaging first. Digital X-Rays show how deep the decay goes and whether the roots and surrounding bone look healthy.
- Numbing. We use Local Anesthesia to put the tooth to sleep. Nitrous Oxide or Sedation Dentistry can help children who are anxious or need several teeth treated.
- Treating the pulp. The decay and affected pulp are gently removed, and a medicated material is placed inside the tooth.
- Protecting the tooth. Because the tooth is weakened, it’s almost always covered with a crown. Your child’s dentist will explain whether Stainless Steel Crowns or Esthetic Crowns are the better fit.
Most children go home the same day eating soft foods, and any tenderness usually fades within a day or two.
Signs your child may need to be seen
- A toothache that comes back or wakes your child at night
- Swelling, a pimple-like bump on the gums or a bad taste in the mouth
- A tooth that has turned gray or dark after a fall
- Sensitivity that lingers after hot or cold food
Call us promptly if you notice swelling or fever along with tooth pain. Our Emergency Dentistry page explains what to do while you wait to be seen.
Is a pulpotomy the same as an adult root canal?
They’re related but not the same. A pulpotomy treats only the top portion of the pulp in a baby tooth, which makes it shorter and simpler than a typical adult root canal.
Will my child be uncomfortable after pulp therapy?
Most children feel some mild tenderness at most. Your child’s dentist may suggest an over-the-counter pain reliever appropriate for your child’s age and weight.
How long will the treated tooth last?
With a well-fitting crown and good home care, a tooth treated with pulp therapy usually stays in place until it’s naturally lost. We’ll keep an eye on it at every checkup.
Related: Dental Crowns, Tooth Extractions, Fillings, Restorative Dentistry