Pulp Therapy Restores Tooth Health in Kids
The "pulp" of a tooth, which contains nerves, tissue, and a network of blood vessels that supply essential nutrients and oxygen, is located in the tooth's center and cannot be seen directly. Pulp can be damaged in several ways. In children, the most common causes are tooth decay or injuries that expose and inflame the sensitive pulp.
Pediatric pulp therapy goes by several names, including root canal, pulpotomy, pulpectomy, and nerve treatment. The main goal of this therapy is to treat, restore, and ultimately save the affected tooth.
Pediatric dentists perform pulp therapy on both primary (baby) teeth and permanent teeth. While primary teeth will eventually be lost naturally, they are crucial for speech development, proper chewing, and guiding the permanent teeth into their correct positions and spacing.
What Are the Warning Signs of Pulp Injury and Infection?
Inflamed or injured pulp is typically very painful. Even if the source of the pain isn't visible, it will quickly become clear that the child needs to see a pediatric dentist.
Here are some other signs to watch for:
- Persistent, unexplained tooth pain.
- Pain that is worse at night.
- Sensitivity to hot and cold foods and drinks.
- Swelling or redness around the affected tooth.
- Unexpected loosening or movement of the affected tooth.
When is Pulp Therapy Necessary for a Child?
Each situation is unique. The pediatric dentist will consider the child's age, the tooth's position in the mouth, and the child's overall health before recommending whether to remove the tooth or try to save it with pulp therapy.
Removing a tooth prematurely can have several undesirable consequences, including:
- The dental arch length may decrease.
- If a primary tooth is lost too early, the permanent tooth underneath may not have enough space to erupt properly.
- The opposing tooth in the other jaw may grow in an abnormal or undesirable way.
- Premolars may become painfully stuck (impacted).
- The remaining teeth may shift to try and fill the empty space.
- The tongue may rest in an unusual position.
How is Pulp Therapy Performed?
Initially, the pediatric dentist will visually examine the affected area and take X-rays. The extent and location of the pulp damage will determine the type of treatment needed. While there are various treatments available, pulpotomy and pulpectomy are two of the most commonly performed procedures in pediatric dentistry.
Pulpotomy
If the pulp in the root of the tooth is healthy and unaffected by injury or decay (meaning the problem is limited to the crown portion of the pulp), the pediatric dentist may leave the healthy part alone and only remove the affected pulp and any surrounding decay. The resulting space is then filled with a biocompatible, therapeutic material that helps prevent infection and soothe the remaining pulp in the root. In most cases, a crown is placed on the tooth after the pulpotomy. The crown strengthens the tooth and reduces the risk of future fractures.
Pulpotomy is a very versatile treatment. It can be used as a standalone procedure on both baby teeth and young permanent teeth, or as the first step in a complete root canal treatment.
Pulpectomy
If there is severe tooth decay or trauma, the entire pulp of the tooth (including the pulp within the root canals) may be affected. In these situations, the pediatric dentist must remove all of the pulp, thoroughly clean the root canals, and then fill the canals with a biocompatible material. This usually requires multiple appointments.
Generally, a material that will be naturally absorbed by the body is used to fill primary teeth, while a non-resorbable material is used for permanent teeth. In either case, the final step is to place a crown on the tooth to provide strength and structural support. These crowns are typically made of stainless steel and are silver in color. Sky Pediatric Dentistry also offers parents the option of white crowns made of zirconium and other tooth-colored materials if aesthetics are a concern.
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