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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.

Pediatric 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 pediatric 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 pediatric 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 pediatric 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 pediatric 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 pediatric 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 pediatric dentist.

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Testimonials

I WISH I COULD GIVE YOU 10 STARS!!!!
Omg!!! SOOOOO happy I found you!!!
I've had these 4 veneers on my front teeth for about 5 years, put on, again, and again and again, after pop offs and cracks and breaks, and several thousands of dollars, by another Santee dentist's office (won't mention who).
After about 4 years of miraculously no problems, I felt a familiar crunch while biting into a fish taco... I was so upset, I just froze staring at this tiny piece of porcelain in my hand. The tears starting welling up as I was reminded of the nightmares I often have of this exact thing happening on a date, or during a job interview... I knew I wouldn't be able to enjoy the rest of my mom's birthday lunch w my daughters, and luckily, I decided to drive myself. I held back the tears, apologized and asked that they wrap up the rest of my meal and I'll see you at home, and ran to my car, wanting to just vomit.... I'm not too vain, am I?
Not just for vanities sake, but the thought of coming up with another 2 grand to fix this, again, was taunting me! My head was spinning. I felt like I had been kicked in the jaw - literally.
First thing I did, after having a few glasses of wine to calm down, was do a search on Yelp. Dr. Fossett was the first to come up -- but still wanted to give my old office a chance, seeing as especially how They WERE THE ONES WHO PUT THE ORIGINALS ON. But, they offered no rest for my weary soul -- no discounts, no deals and no financing. And a replacement will cost @2000!!
I called Dr. Fossetts office next and was enchanted by Robyn, who understood my plight and offered all the help she could; gave me a rough estimate on cost (final cost was LESS than what she quoted!), and applied for Care Credit for me over the phone.
I could go on and on about how my appointment went -- didn't even have to sit or wait, was brought back for a consultation immediately. Not expecting to have everything even started the same day, the assistant and Dr. Dave came back in two minutes and said, let's get started!
Not more than 30 minutes later, I looked in the mirror to the most gorgeous "Temporary" veneer I have ever seen!! I mean, I'd be happy w this for years! The last office would spackle on this horrible looking crap that had no esthetically pleasing value at all!! THIS is a premier job!
And I'm a chronic perfectionist! Especially when it comes to my looks (hair, teeth, ect).
SO IF IM HAPPY, YOU BETTER KNOW THE JOB WAS STELLAR!!!
Thank you Dr. Fossett and staff-- THANK YOU!!!

Vanessa M.

Yesterday was my first visit to this wonderful Dental office. I haven't felt more welcome and comfortable in a Dental facility since I was 19... Now 31 years young. I grew up, going to a father/son dental group and Dr. David and Dr. Douglas Fossett had the same family centered vibe and conservative but smart dental care I've been searching for! As a Registered Nurse, quality care and patient centered care is the core of my own practice. Dr. David and Dr. Douglas exemplify this to a tee! I've finally found my go to family Dental office. I feel like a weight has been lifted off my shoulders after getting a second option from these very well informed Dentists!

Haylee R.

Great office!!! From the moment I walked in I felt very welcomed by the staff. I'm always nervous when going to the dentist no matter how many times I go, however after my visit to Dr. Fossett's office I felt much more relaxed and at ease. They did everything they could to make me comfortable. I felt the staff was very knowledgeable and answered any questions I had. The assistants are top notch . The smiles , kind hearts and exceptional service will keep me coming back. Thank you to the office for a positive experience.

Rachel Y.

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