The terms “pulpotomy” and “root canal” are often mistakenly used interchangeably, as both procedures involve treating the delicate dental pulp inside a tooth. The pulp contains the tooth’s nerves and blood vessels. When the pulp becomes infected or inflamed, intervention is necessary to save the tooth. While both are forms of pulp therapy, they are distinct treatments with different scopes, applications, and goals. Understanding the differences between these two common dental procedures is important for patients seeking treatment for tooth pain or decay.
Defining the Pulpotomy: Partial Pulp Therapy
A pulpotomy is a conservative endodontic procedure primarily performed on primary teeth (baby teeth). This treatment is recommended when decay or trauma has affected the pulp tissue within the crown, but the pulp in the root canals remains healthy. The procedure involves carefully removing only the infected or inflamed pulp from the pulp chamber, located in the center of the tooth crown.
The remaining healthy pulp tissue within the root canals, known as the radicular pulp, is intentionally left intact. After the coronal pulp is removed, a medicated material is placed over the remaining pulp to promote healing. This partial removal allows the tooth to remain functional. This is important for primary teeth, as they hold the necessary space for the permanent teeth that will eventually erupt.
The main objective is preserving the primary tooth until its natural exfoliation, which helps guide the permanent successor into the correct position. Following the pulpotomy, the tooth is typically restored with a filling or a full coverage stainless steel crown to protect the structure and seal it against new bacteria.
The Full Root Canal: Complete Endodontic Treatment
The procedure commonly referred to as a root canal is a comprehensive endodontic treatment designed for the complete removal of all pulp tissue. This treatment is necessary when the infection or damage has progressed beyond the crown, reaching the radicular pulp and extending deep into the tooth’s root system. The root canal is typically performed on permanent teeth.
During this extensive treatment, the entire pulp, including both the coronal and radicular portions, is removed. The dentist or endodontist creates an access opening in the crown to reach the pulp chamber and the root canals. Specialized instruments are used to clean, shape, and disinfect the entire inner cavity of the tooth.
Once the tooth is free of infected tissue, the canals are filled with a biocompatible, rubber-like material called gutta-percha to seal the space. This sealing prevents future bacterial contamination. The final step involves placing a permanent filling or a dental crown over the treated tooth to restore its strength and ensure its long-term functionality.
Why They Are Not the Same Procedure
The key distinction between a pulpotomy and a root canal lies in the extent of the pulp tissue removal. A pulpotomy is a partial treatment that removes only the infected pulp from the tooth’s crown, preserving the healthy tissue in the roots. In contrast, a root canal requires the complete removal of all pulp from both the crown and the entire length of the root canals.
This difference in scope relates directly to the type of tooth and the severity of the infection. A pulpotomy is reserved for primary teeth with limited infection, aiming to maintain the tooth’s vitality until it naturally falls out. The root canal is the standard for permanent teeth where the infection is extensive, and the goal is to permanently save the tooth.
The pulpotomy manages a localized infection to allow for natural exfoliation. The root canal, however, is a reconstructive procedure that renders the tooth non-vital by removing the nerve and blood supply, allowing the permanent tooth to be preserved indefinitely. The choice depends on the dentist’s assessment of the pulp’s health and the patient’s age.