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Children and Dental Pulp Therapy

If primary molars have cavities to the nerve space, often they can be saved with a vital pulpotomy to keep the tooth.  Sometime a child's permanent molar or front tooth is damaged from decay or trauma and may be able to be kept with endodontic therapy treating the pulp of the young permanent tooth.

Although both treat the nerve space of a tooth, the vital pulpotomies treat the top half in attempt to preserve the roots and primary tooth until the normal time of replacement by the permanent tooth.  A root canal, is a relatively painless treatment which aims at clearing infection inside the root in a permanent tooth.  When a tooth is cracked or has a deep cavity, bacteria can enter the pulp tissue and germs can cause infection. If left untreated, an abscess may form. If the infected tissue is not removed, pain and swelling can result.

What happens during pulp therapy?

Primary molars:  the top of the inside pulp is removed and the tips of the root pulp tissue is treated with medication, then a biocompitable dressing is placed to help the tooth remain until its normal time to fall out.  Primay molars need a preformed crown since the tooth is weaker after after treatment.

Permanent teeth:  The pulp of the tooth is removed to the root tips and sealed with a natural rubber (Gutta Percha) and biocompatible sealer.  Many times this can be accomplished in a single appointment, however it can be a long appointment.  Often children needing root canal therapy on permanent teeth require sedation so they can be still long enough for successful care.

Root canal treatment involves one to three visits during which a dentist endodontist removes the affected tissue.  After the tissue is removed, the interior of the tooth will be cleaned and sealed.    The access hole is bonded and built up with a dental composite after endodontic treatment. If your tooth had extensive decay, a crown may be needed to strengthen and protect the tooth from breakage. As long as you continue to care for your teeth and gums with regular brushing, flossing, and checkups, your restored tooth can last a lifetime.

Most teeth can be saved by endodontic therapy. However, tooth extraction may be necessary if:

  • Roots are severely fractured
  • The tooth does not have adequate bone support
  • The tooth cannot be restored
  • Root canals are not accessible

Pulp therapy is intended to help save a tooth from extraction. If a primary molar is extracted, the developing bite is likely to have crowding from shifting into the space from the extracted tooth. Missing permanent teeth can make you self-conscious, affect your ability to bite and chew, cause other healthy teeth to shift, and have a negative impact on your overall health. Pulp therapy can help keep a bite and smile intact for years to come.