A pulpotomy is a dental procedure designed to treat and save a tooth when its inner soft tissue, known as the pulp, becomes damaged or infected. The main objective is to preserve the tooth’s structure and function, preventing its complete removal.
Understanding a Pulpotomy
A pulpotomy addresses damage to the tooth’s pulp, which contains nerves and blood vessels, primarily within the crown portion. This soft tissue can become inflamed or infected due to deep tooth decay. When a cavity progresses significantly, bacteria can reach the pulp, leading to a condition called pulpitis. Trauma to a tooth, such as a crack or fracture, can also expose the pulp to bacteria, necessitating a pulpotomy.
Dentists often recommend this procedure for primary, or baby, teeth in children. Preserving baby teeth is important because they help maintain proper spacing for the permanent teeth that will emerge later.
The Pulpotomy Procedure
The pulpotomy procedure typically begins with the application of a local anesthetic to numb the area around the affected tooth, ensuring patient comfort. In some cases, a mild sedative may also be used, especially for anxious children. A dental dam, a thin, flexible rubber sheet, is then placed to isolate the tooth and keep it dry during the treatment.
The dentist carefully removes any existing tooth decay and then accesses the pulp chamber by drilling through the enamel and dentin. Once the pulp chamber is exposed, the infected or inflamed pulp tissue from the crown is gently removed. It is important that the remaining pulp in the tooth’s root canals remains healthy and vital for the procedure to continue.
After the infected coronal pulp is removed, the area is cleaned, and a medicated material is placed over the remaining healthy pulp. Common medicaments include mineral trioxide aggregate (MTA), ferric sulfate, or formocresol, which help to promote healing and maintain pulp vitality. Finally, the tooth is sealed with a dental filling or, more commonly, a crown, often a stainless steel crown, to restore its function and protect it from further damage.
After the Pulpotomy
Following a pulpotomy, it is common to experience some mild discomfort, tenderness, or sensitivity to temperature changes for a few days. Over-the-counter pain relievers, such as acetaminophen or ibuprofen, are typically sufficient to manage any pain. If pain persists or worsens, contacting the dental office is advised.
Patients should avoid eating or drinking while the mouth is still numb to prevent accidentally biting the cheek, lip, or tongue. For the first 24 to 48 hours after the procedure, a soft food diet is recommended to minimize pressure on the treated tooth. Foods like yogurt, mashed potatoes, and soup are suitable options. Hard, sticky, or crunchy foods should be avoided until the tooth is fully restored or sensitivity subsides.
Maintaining good oral hygiene is important for healing. Gentle brushing with a soft-bristled toothbrush and regular flossing around the treated tooth are encouraged, taking care not to dislodge any temporary restorations. Follow-up appointments with the dentist are important to monitor the tooth’s healing and ensure the success of the pulpotomy.
Pulpotomy vs. Root Canal
While both pulpotomy and root canal therapy treat issues within the tooth’s pulp, they differ significantly in their scope and application. A pulpotomy involves removing only the infected pulp tissue from the tooth’s crown, aiming to preserve the healthy pulp in the root canals.
In contrast, a root canal, also known as endodontic therapy, requires the complete removal of all pulp tissue from both the crown and the root canals. This more extensive procedure is performed when infection or damage has spread throughout the entire pulp system.
Pulpotomies are most commonly performed on primary (baby) teeth, helping to keep them in place until they naturally fall out. Root canals, however, are generally reserved for permanent teeth.