Pulpectomy, The Gentlest Way To Treat Caries In Children’s Teeth
What is a Pulpectomy?
I have been told my child needs a pulpectomy – why can’t he just have a normal filling?
It’s just a baby tooth – wouldn’t it be better to pull it out?
Baby teeth maintain the spaces for permanent teeth to erupt into. If baby teeth are lost too early other teeth may tilt into or take up the vacant space, forcing permanent teeth to come in crooked.
If the baby tooth is getting close to being pushed out by the adult tooth that replaces it, a pulpectomy may not be advised. This can be judged by looking at an x-ray of the teeth. In this case the baby tooth can be left to fall out naturally or, if there is spreading infection, may need to be extracted.
How is a pulpectomy done?
- An opening is made through the top of the tooth. If the nerve is not completely dead, local anaesthetic will be required to numb the tooth first – click here for more information on this.
- The decay and infected nerve are removed. The root canals are cleaned and shaped using small files and then washed and dried.
- The empty root canal space is then filled with a paste which is able to resorb as the tooth root loosens to make way for the new adult tooth.
- A filling is then placed in the top part of the tooth. An x-ray will be taken to check the root filling.
Most teeth with pulpectomies will require a crown (cap), as when the nerve is dead or removed the tooth is more brittle and more likely to fracture. For baby teeth near the back of the mouth a pre-formed metal crown is most often used. This may be done or the same or the next visit.
Clinical studies have shown a 78 to 96% success rate with the latest materials use for filling root canals in baby teeth.
- Avoid eating and drinking for the first 20 minutes.
- If your child had local anaesthetic to numb the tooth they will need to be careful not to bite their lip or tongue until the numbness has worn off.
- On the day of treatment it is best to stick to softer foods that don’t require a lot of chewing and avoid very hot food and drinks.
- There is sometimes some mild pain or discomfort as the tooth settles down. This can be relieved using children’s paracetomol. (Calpol or Crocin).
- Your child should avoid biting heavily on the tooth until it is restored with a crown, as it may be brittle and prone to fracture.
- The teeth should be brushed normally.