What is Pulp Therapy?

The “pulp” of a tooth cannot be seen with the naked eye. Pulp is found at the center of each tooth, and is comprised of nerves, tissue, and many blood vessels, which work to channel vital nutrients and oxygen.  There are several ways in which pulp can be damaged.  Most commonly in children, tooth decay or traumatic injury lead to painful pulp exposure and inflammation.

Pediatric pulp therapy is known by several other names, including: root canal, pulpotomy, pulpectomy, and nerve treatment.  The primary goal of pulp therapy is to treat, restore, and save the affected tooth.

Dentists perform pulp therapy on both primary (baby) teeth and permanent teeth.  Though primary teeth are eventually shed, they are needed for speech production, proper chewing, and to guide the proper alignment and spacing of permanent teeth.

What are the signs of pulp injury and infection?

Inflamed or injured pulp is exceptionally painful.  Even if the source of the pain isn’t visible, it will quickly become obvious that the child needs to see the dentist.

Here are some of the other signs to look for:

  • Constant unexplained pain.
  • Nighttime pain.
  • Sensitivity to warm and cool food temperatures.
  • Swelling or redness around the affected tooth.
  • Unexpected looseness or mobility of the affected tooth.

When should a child undergo pulp therapy?

Every situation is unique.  The dentist assesses the age of the child, the positioning of the tooth, and the general health of the child before making a recommendation to extract the tooth or to save it via pulp therapy.

Some of the undesirable consequences of prematurely extracted/missing teeth are listed below:

  • Arch length may shorten.
  • In the case of primary tooth loss, permanent teeth may lack sufficient space to emerge.
  • Opposing teeth may grow in a protruding or undesirable way.
  • Premolars may become painfully impacted.
  • Remaining teeth may “move” to fill the gap.
  • The tongue may posture abnormally.

How is pulp therapy performed?

Initially, the dentist will perform visual examinations and evaluate X-rays of the affected areas.  The amount and location of pulp damage dictates the nature of the treatment.  Although there are several other treatments available, the pediatric pulpotomy and pulpectomy procedures are among the most common performed.

Pulpotomy - If the pulp root remains unaffected by injury or decay, meaning that the problem is isolated in the pulp tip, the dentist may leave the healthy part alone and only remove the affected pulp and surrounding tooth decay.  The resulting gap is then filled with a biocompatible, therapeutic material, which prevents infection and soothes the pulp root. Most commonly, a crown is placed on the tooth after treatment.  The crown strengthens the tooth structure, minimizing the risk of future fractures.

Pulpotomy treatment is extremely versatile.  It can be performed as a standalone treatment on baby teeth and growing permanent teeth, or as the initial step in a full root canal treatment.

Pulpectomy - In the case of severe tooth decay or trauma, the entire tooth pulp (including the root canals) may be affected.  In these circumstances, the dentist must remove the pulp, cleanse the root canals, and then pack the area with biocompatible material.  This usually takes several office visits.

In general, reabsorbable material is used to fill primary teeth, and non-reabsorbable material is used to fill permanent teeth.  Either way, the final treatment step is to place a crown on the tooth to add strength and provide structural support.  The crown can be disguised with a natural-colored covering, if the child prefers.

If you have questions or concerns about the pediatric pulp therapy procedure, please contact your dentist.

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Testimonials

I recently decided I wanted a smaller practice for my kids and after really dragging my feet I finally dove into Google. I found Dr. Thomas and her team and they got my kids in quickly to start treatment plans.
To start, the staff is so friendly and they truly go above and beyond at the front desk! Scheduling appointments comes with ease as well. My kids do great with the dental assistant and she has the perfect demeanor for little ones. Dr. Thomas has such patience with my youngest who can be a bit dramatic and a little spacey too. My older boy is so calm for her and she does a great job working on him as well.
We meet the hygienist next month and I have no doubt the experience will be as satisfactory as all the others.

Morgan T.

Hands down the BEST dentist you will find - I dare someone to challenge me ❤️ They have the absolute friendliest staff we have ever come across and Dr. Thomas is amazing! Every time we are there, we feel like we are visiting with friends and family. All of the staff makes a point to see how we are doing and they truly listen to us and genuinely care. My husband and I have been coming here for almost 10 years now. They are very honest as well regarding dental concerns and needs. We were super nervous when it came time for our son to start coming but we soon found out we had NOTHING to worry about! He is 3 1/2 years old now and LOVES the dentist! They are so wonderful with him and are encouraging/teaching him so many wonderful dental habits. He actually is excited about brushing his teeth every day! We are so lucky to have found them. If you are looking for long term dentist - look no further! We actually travel 20+ minutes to come here. It’s worth it! Thank you all so much ❤️❤️

Meagan S.

Dr. Thomas and her staff make going to the dentist a fun experience…that has to be a first when it comes to talking about a dental visit!!! This was my first time and you have a patient for life…or for as long as you can make sure I keep my teeth. What a great office and Karen was amazing as well. Usually post dental visit I feel like I’ve been in a boxing fight, even though it was just for a cleaning. This time I felt nothing. I give Dr. Thomas and her team my highest recommendation.

Shaju T.

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