Pulpotomies
Pulpotomy involves relieving pain and discomfort by removing the nerve tissue (called pulp ) located in the center of a primary ( baby ) tooth. Treatment involves drilling through the biting surface of the tooth to expose the diseased pulp, which is removed and treated. Medications are used to sterilize the interior of the tooth to prevent further infection.
After the diseased portion of the pulp has been removed and treated the resulting cavity is sealed with cement and a restoration such as a crown or filling is placed. In most cases this treatment can be completed in one visit however, if additional visits are required, it is essential to return promptly to have that treatment completed. Benefits and alternatives
Pulpotomies are done to enable the infected tooth to be retained and used without pain or discomfort until it is lost normally when it is replaced by the permanent tooth. Extraction is the most common alternative to pulpotomy. This alternative results in decreased function in the area and a loss of space for the permanent tooth as the other teeth drift into the extraction area. This can require orthodontic treatment ( braces ) later to correct the crowding and crooked alignment.
Common risks
- Pain, soreness, and infection: Usually there is minimal pain, soreness, or infection after this treatment, however if the tooth was badly infected there may be some residual discomfort. Sometimes an antibiotic is prescribed to clear any residual infection. Slight discomfort is usually treated with an over-the-counter pain reliever such as Tylenol or Advil.
- Perforation: Occasionally the decay, infection, or treatment results in a hole through the tooth into the bone. If this is seen during the treatment the tooth is usually removed, however if the abscess does not heal after treatment it is usually assumed that a perforation is present and the patient is scheduled to have the tooth removed.
- Overfill: Sometimes the cement filling material is forced out though the tip of the roots into the surrounding bone and tissue. This usually causes little or no problem, however if there seems to be discomfort or incomplete healing after the treatment an X-ray can identify if this is the problem and the excess material can be removed.
- Cracking or fracture: Teeth that have had pulpotomies become more brittle and more prone to cracking or breaking. To protect from fracture and further infection, a crown is almost always placed on a tooth that has had a pulpotomy. If the treated tooth has had a filling only, there is a chance that it might fracture and require further treatment.
- Loss of bone support: A severe or longstanding infection can destroy bone around the tooth causing the tooth to be loose. Usually this will heal after pulpotomy treatment however; sometimes it is too advanced. If it does not heal after treatment, the tooth may need to be removed.
Consequences of not performing treatment
This treatment provides the best chance of preserving and restoring an abscessed tooth to comfort and function. Delaying or neglecting treatment could result in a serious, potentially life threatening infection and the loss of the tooth.
Every reasonable effort will be made to ensure that the pulpotomy will be done properly, although it is not possible to guarantee perfect results. Some pulpotomies fail even after our best effort. By signing the consent form, you acknowledge that you have received adequate information about the proposed treatment, that you understand this information and that all of your questions have been answered fully.