When tooth decay is severe, your dentist may recommend pulp therapy (also referred to as a pulpotomy or pulpectomy) to relieve pain and restore the tooth.

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What is pediatric pulp therapy and what are the benefits?

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Although teeth are mostly made up of hard bone, they can still feel temperatures and pressure. This is because of what is called the pulp in the tooth. Pulp is made up of nerves, blood vessels, and other tissue and is found in the center of each tooth. Pulp is what allows our teeth to receive oxygen and important nutrients that help keep them healthy.

 

When pulp is exposed through injury or tooth decay, it can cause a lot of pain and inflammation. In order to prevent extracting the tooth, your child's pediatric dentist may recommend pulp therapy, sometimes referred to as nerve therapy. This can sometimes be an alternative to a traditional root canal or dentures and can preserve teeth that may otherwise be lost.

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Why is pulp therapy recommended?

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Pulp therapy is most often recommended for children in order to preserve baby teeth and prevent spacing issues.    

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What is a pulp therapy procedure like?

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There are typically two different possible procedures used in pediatric pulp therapy: a pulpotomy or a pulpectomy. Both procedures showed high success rates of around 94% or more over several years in a study published by PubMed.

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A pulpotomy is employed when only part of the pulp of a tooth is infected and involves removing that infected pulp and preserving the nerve and remaining pulp. During this procedure, the dentist will give the child a local anesthetic shot, wait for the area to numb, and begin by removing the infected pulp. After the infected portion is gone, a plugging agent is installed to calm the pain in the nerve and prevent future infection. Finally, a crown is placed over the tooth to give it strength and reduce fracture risk in the future.

 

A pulpectomy is recommended when the entire pulp is infected requiring complete removal of the pulp. This procedure also requires a local anesthetic. After the child’s mouth is numbed, the dentist removes all of the tooth’s pulp and cleanses the area to ensure all of the bacteria is removed. Then, if it is a baby tooth, it is filled with a material that can be reabsorbed by the body. Otherwise, it receives a permanent filling and crown at this point. 

 

What aftercare is needed?

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After a pulpotomy or pulpectomy, your child’s mouth will remain numb for a few hours. Take care to monitor any food or liquid intake while the mouth is still numb and restrict eating to soft foods. After the numbness subsides, your child may have some swelling and pain over the next day or two. These can be managed with ice packs and over the counter pain medications such as ibuprofen or acetaminophen. If pain continues after a couple of days, it is best to contact your child’s dentist.

 

Depending on the severity of the tooth infection, the dentist may prescribe antibiotics following the treatment to ensure the infection is eliminated. Be sure to follow dosage instructions and continue medicine until it is completely used, even if the tooth feels well.