What Is A Pulpotomy?
The suffix “-otomy” means “cut off,” so a pulpotomy is an operation that “cuts off” the pulp. The pulp is the tissue inside a tooth that provides the blood supply necessary for the initial formation of the tooth, and it also has nerve endings to warn us of infection or irritation in the tooth.
When a permanent tooth becomes infected, a pulpotomy can be done as a temporary treatment to halt the progress of the infection and relieve the toothache. The bulk of the pulp tissue is removed from the tooth and a disinfectant is placed and sealed inside. The root canal treatment is then finished later.
When a baby tooth becomes infected, it may not be practical or possible to do a root canal treatment on the tooth. With baby molars especially, because of the shape of the roots, they can be impossible to seal. Plus, a baby tooth will only be present in the mouth up until age twelve maximum. If it is only going to be a couple of years before the tooth falls out, a pulpotomy can be sufficient to hold off the infection for that long, and then the tooth will fall out and be replaced by its permanent successor.
The Pulpotomy Procedure
A dentist may or may not know from the x-rays that a baby tooth is infected. Often it is in the process of removing the decay that the infection is confirmed. At the point when it is discovered that the baby tooth is infected, the bulk of the pulp of the tooth, down to where the roots begin, is removed with a handpiece. If the living tissue remaining in the tooth is healthy enough, the dentist will be able to stop the bleeding of that tissue with a cotton pellet and waiting about five or ten minutes. If he or she can’t get the bleeding to stop that way, it’s an indication that the tissue is not healthy enough for a pulpotomy and the baby tooth will have to be removed. If the bleeding does stop, then the dentist will daub a disinfectant, often formocresol, on the tissue and then seal the tooth with a filling material.
A baby tooth with a cavity large enough to be infected is probably weak enough that it needs the protection of a crown. Again, because this is a tooth that will fall out before very many years, the crown procedure is simplified by using a prefabricated crown, such as a stainless steel crown or a polycarbonate crown.
A successful pulopotomy treatment will last without any complications or need for maintenance until the baby tooth falls out, which could be as long as nine years.
Some parents may wonder why even bother, if the tooth will fall out anyway. But keeping these teeth healthy can be important. Yes, if the baby tooth is a front tooth, it can fall out without any complication. But if it’s a baby molar, which is the case with almost all pulpotomy cases, and the tooth is lost prematurely, the permanent dentition will become a jumbled mess. With no teeth present to hold their position, the permanent six year molars will drift forward. Then, at age 10 to 12, when it’s time for the permanent premolars to come in, there won’t be space for them and they may be forced out sideways.
If a baby molar can’t be saved and has to be extracted, then often a space maintainer is used to hold that space for the permanent tooth.