What Is a Pulpotomy?

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My son has a toothache and I took him in to see a pediatric dentist. We don’t have a lot of money. He was diagnosed with an infected tooth. My dentist is suggesting a pulpotomy. When I tried to ask questions about it he appeared to get annoyed and indicated that he had other patients. I do understand that. I wouldn’t want to be stuck waiting while someone else asked a bunch of questions. However, I cannot in good conscience subject my son to a procedure without understanding what it is and why it is necessary. Can you help me? I’m also wondering if it is better to just let the baby tooth fall out on it’s own? It surely won’t last much longer.

Presley

Dear Presley,

You are a good mother. You are also extraordinarily understanding. I don’t know that I would be so gracious if my child’s dentist had ignored my request to understand what he or she wanted to do with my child. While every dentist should be willing to take the time to explain to patients his recommended treatment, I feel this is especially important with a pediatric dentist. Parents have the ultimate responsibility for their children. As you know, they love and worry about them constantly. The least you should expect from your child’s dentist is the willingness to explain a diagnosis and treatment recommendation to them.

What is a Pulpotomy?

A pulpotomy is essentially a child’s version of a root canal treatment. After the treatment, the tooth will be covered with a dental crown. For children, that is usually a stainless steel crown.

When a child has an infected tooth, you have two options for treating it. The first is to extract the tooth. The second is a pulpotomy. I would not leave an infected tooth in a child’s mouth, even a baby tooth. This is because tooth infections, when left untreated, will spread. These can spread to other parts of his body and become life threating.

Should you do a pulpotomy or an extraction? For adult teeth, I would recommend an extraction as a last resort. But, with a baby tooth, the only time I think you need to do a pulpotomy is with a back tooth. His baby molars need to stay in place until he is twelve years old. Otherwise, you risk the other teeth shifting because of the open space. Then, when his adult molars do come in, there is not room for them, leading to crowding and expensive orthodontics. If it is not a back tooth, then extracting it is fine.

What will you do if the back tooth can’t be saved with a pulpotomy? In that case, don’t panic. Your dentist can place a space maintainer there to hold the space open.

I hope this helps and puts your mind at ease.

This blog is brought to you by Lafayette, LA Medicaid Dentist Dr. DeJean.