Pulpotomies and Nerve Therapy for Baby Teeth

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Is root canal therapy for primary (baby) teeth ever a necessity? If your child is in pain from an abscessed tooth, then treatment is a must. But unlike adult teeth that are treated with a traditional root canal, primary teeth are best managed with something called a pulpotomy.

Illustration depicting a pulpotomy procedure on a baby tooth.

Symptoms of Abscessed Teeth

Dental abscesses are infections that start out as tooth decay, but eventually infect the nerve inside of the affected tooth.

Symptoms often include:

  • A visible hole or fracture on the tooth
  • Swelling along the gums
  • Possible discharge from the tooth or gums
  • Difficulty eating
  • Tooth pain or sensitivity

Not all abscessed teeth hurt. For an accurate diagnosis, our dentist will need to take a small X-ray of the tooth that captures the entire root structure. If a visible lesion or cyst is located near the tip of the root, we know that the nerve has been compromised.

What is a Pulpotomy?

Similar to root canal treatment, pulpotomies treat the infected nerves of teeth. Only in this case, it’s primary teeth in children. But instead of removing the nerve and then filling the empty canal with a permanent material, we medicate and seal off the nerve chamber. The goal is to preserve the tooth until it’s closer to time for it to fall out naturally. By leaving the canal intact, the tooth can naturally resorb as it comes time for the permanent one to replace it.

Although pulpotomies are not the same as traditional endodontic therapy, it’s still common for people to refer to them as “baby root canals.”

Will My Child Need a Crown, Too?

Every tooth that’s treated with a pulpotomy will also need a dental crown. Since baby teeth are extremely fragile, crowns reinforce them against everyday biting and chewing pressures. Otherwise, the remaining and brittle tooth enamel would quite possibly fracture from normal use.

Depending on where the tooth is located, a temporary stainless steel crown or aesthetic strip crown will be used. Both of these restorations provide adequate coverage and protection for everyday meals. But they’re not quite as “heavy duty” so to speak as a permanent porcelain crown.

Without a crown, primary teeth that have been treated with pulp therapy won’t last for the intended amount of time. A crown is crucial to making your child’s pulpotomy a success.

Nerve Therapy vs. Tooth Extraction

You may be asking yourself, “If my child is going to lose their tooth eventually anyway, why should they get a pulp and crown?” That’s an excellent question. In short, the pulp therapy and crown are meant to help extend the normal amount of time that your child’s baby tooth lasts in their mouth. It limits the chances of premature tooth loss.

If your child lost the tooth too soon — let’s say it was extracted instead — the surrounding teeth would start to shift out of alignment. The teeth adjacent to the open space might close in on one another, impacting the adult tooth that’s developing underneath. In turn, a chain reaction across your child’s mouth causes generalized tooth displacement and orthodontic concerns.

The only times we recommend extracting a tooth instead of a pulpotomy is if the tooth is non-restorable or close to exfoliating (falling out naturally.) Or perhaps your child is in such severe pain due to an aggressive infection, that the best option is to take the tooth out immediately.

If for any reason the tooth is extracted well ahead of the natural exfoliation time, we will need to put a space maintainer in that location. Doing so will help to avoid the common complications of premature tooth loss.

Risks of Untreated Abscesses

In extremely rare circumstances, abscessed teeth can result in facial or even brain infections, requiring hospitalization. Even if your child is not in pain, it’s crucial to treat active infections soon after their diagnosed. Delaying a pulpotomy even by a month or so could result in an unnecessary medical or dental emergency.

Gentle Care for Your Child

A severe oral infection such as a dental abscess can potentially add to anxiety. Just one bad experience is enough to contribute to a lifetime of dental phobia. It’s our top priority to see to it that your child is as comfortable as possible at all times. Our friendly staff will work at your child’s pace and take special measures to thoroughly numb the tooth that’s being worked on.

If you suspect that your child has a large cavity or abscess, contact us immediately to schedule an appointment. Call (617) 527-6061 or request an appointment online.

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Schedule Your Appointment Today

If your child is due for a dental exam and/or cleaning, contact Waban Dental Group. We happily accept new patients and we offer convenient hours to accommodate your schedule. Our office is well equipped with the latest technology and knowledgeable staff. Even if your child is a little older or if it has been years since their last checkup, contact us! Our team will recommend treatment plans that best suit your child’s needs. Call (617) 527-6061 or request an appointment below. 

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We are pleased to be in-network with Delta Dental Premier. Speak with our knowledgeable team to discuss your insurance & payment options today. Our friendly staff will work with you to make payment for your treatment convenient and simple.