What a pulpotomy actually is
When decay reaches the nerve inside a baby tooth, the tooth cannot heal itself. A pulpotomy removes the infected part of the nerve from the crown of the tooth, treats what remains, and seals it.
It is not the same as an adult root canal. In an adult tooth the whole nerve is removed down through the roots. In a baby tooth the roots are going to dissolve naturally anyway, so only the upper portion is treated.
The tooth is then almost always covered with a crown, because a tooth that needed a pulpotomy is usually too weakened to survive on a filling alone.
Signs a baby tooth may need one
- Toothache that wakes your child at night, rather than only when eating
- A visible hole, or a tooth that has turned grey or dark
- Swelling of the gum or face near the tooth
- A small pimple like spot on the gum, which is a draining abscess
- Sensitivity to hot or cold that lingers after the food or drink is gone
- Your child avoiding chewing on one side
What the appointment involves
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An image first
We take an image to see how far the decay has gone and whether the tooth can be saved. Sometimes it cannot, and we will tell you that plainly rather than attempting it.
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Numbing, properly
The area is fully numbed before anything starts. This is the part that determines whether your child has a good experience, so we do not hurry it.
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The pulpotomy
The decay and the affected nerve tissue in the crown are removed, the area is treated and sealed.
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A crown over the top
A stainless steel or tooth coloured crown is fitted the same day so the tooth can handle chewing for the years it still has left.
Who you will see
Dr. Brian Hwangpo looks after baby root canals at our Bishop Arts practice. You see the same dentist at every visit, so nobody starts your treatment over.
What it costs, and how people pay
Price depends on what you actually need, so we look first and tell you the number before anything starts. What we can tell you now is how it gets paid for.
- Insured. In network with most major PPO plans, and your benefits get checked before treatment is planned.
- Medicaid or CHIP. Both accepted, which a lot of Dallas practices will not do.
- No insurance. Our membership plan covers cleanings, exams and routine x-rays from $30 a month, with 20% off other treatment.
- Larger treatment. Cherry, Sunbit and HFD payment plans spread the cost.
Baby Root Canals questions
- Why does a baby tooth need a root canal if it is going to fall out?
- Because it is holding space for the adult tooth. Losing it early lets the neighbouring teeth drift into the gap, which can leave the adult tooth without room to come through and lead to orthodontic treatment that would not otherwise have been needed.
- What is a pulpotomy?
- It is the removal of infected nerve tissue from the crown portion of a baby tooth, followed by treating and sealing what remains. Only the upper part of the nerve is treated, because the roots of a baby tooth dissolve naturally.
- Does a pulpotomy hurt?
- The tooth is fully numbed first, so the procedure itself should not. Most children are more bothered by the numb feeling afterwards than by anything during the appointment.
- How long does a baby tooth last after a pulpotomy?
- The goal is for it to stay until it is due to fall out naturally. With a crown over it, that is usually what happens.
- Is extraction better than a pulpotomy?
- Sometimes, if the tooth is too damaged or the infection has spread too far. But where the tooth can be saved, keeping it is almost always better than removing it and then needing a space maintainer.