Pediatric Pulpal Therapy

What is pediatric pulpal therapy?

Pediatric pulpal therapy is a pediatric dental treatment used to treat and preserve a child's natural tooth that has been affected by an injury or tooth decay. The pulp is soft tissue located inside the teeth. When a tooth becomes damaged or decayed, the pulp may be exposed to bacteria, causing infection and pain.

Reasons for pediatric pulpal therapy:
  • 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


The 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.

What to expect during pediatric pulpal therapy

Initially, visual examinations and X-rays of the affected areas will be performed. The amount and location of pulp damage dictate the nature of the treatment. Although there are several other treatments available, the pediatric pulpotomy and pulpectomy procedures are among the most commonly 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, re-absorbable material is used to fill primary teeth, and non-re-absorbable 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.