Pulpectomy is a dental treatment that involves complete removal of pulp tissue from a baby tooth.  Last week, we covered several root canal-type procedures your child might need if for a deep infection in a baby tooth.  You might want to read and review it before checking out this one.  Just as we promised in our previous blog, the “Dentistry for Children Blog” brings you the details about the pulpectomy procedure in Part 2 of our fresh look at pulpectomy for 2019.

Pulpectomy:  What’s in a Name?


Explaining the Pulpectomy Procedure May Calm the Child’s Fear

As you might have guessed by the name, pulpectomy is a procedure that requires the total removal of all the pulp tissue within a baby tooth because it is infected.  Pulp indicates the dental live tissue at the heart of the tooth.  And ectomy means the removal of.  Appendectomy is a close example of this type of medical language.

Naturally, the primary objection that parents voice about the pulpectomy is giving a concentrated amount of attention to a baby or primary tooth.  Parents cannot resist telling us this tooth is going to fall out anyway.”  Yes, we say, we know, but we want it to fall out at the proper time.  Until then it can protect the precious bud of the permanent tooth under it and hold a proper space for it to grow into.

As we explained in Part I of our two-part series on Root Canals in Baby Teeth, the spacing of your child’s teeth and the position they occupy in the mouth are important to the development of the permanent teeth.  As a pediatric dentist, Dr. Troy King believes that saving the infected baby tooth is important to how your child learns to eat, and talk.  Likewise, after the pulpectomy, your child’s tooth will be structurally sound and still be shed normally when it is the proper time.

Your Child’s Pain and Swelling

Often there is pain and swelling within the gum tissues or even the cheek, the classic “tooth-ache” profile.  Your dentist will attend to this issue first before proceeding with the pulpectomy.  Likewise, he will review the child’s health and dental history and make an extensive examination.

That being said, you should know this is the most serious, last-ditch effort to save the structure of the tooth.  We discussed less drastic measures in our previous blog.

A Pulpectomy Is Painless When Properly Done

Pulpectomy can frighten a child.

Confidence from Mom is Contagious.

With the use of local anesthesia, and with your calm confidence, your child will be ready for the dentist to work on his or her sore tooth.

A rubber dam will isolate the tooth and keep it dry for the procedure.  Although it looks strange to you, it will protect the rest of the mouth and make the process more comfortable for your child.

For our deep readers, the AAPD gives all dentists guidelines for judging that the tooth justifies a pulpectomy.

Medically, pulpectomy is indicated “in a primary tooth with irreversible pulpitis or necrosis or a tooth treatment planned for pulpotomy in which the radicular pulp exhibits clinical signs of irreversible pulpitis…”  In plain language, this means that the pulp of the tooth is so severely infected it will never get well.

Step By Step, Pulpectomy and Restoration of the Tooth:

1.  First, the dentist will drill a small opening into the biting surfaces.

2.  This opening will drain the infection.  Then the dentist will prescribe a course of antibiotics.

3.   After applying local anesthesia, the stage is set for removal of the infected tissue from the root canal.

4.   If you ever had a root canal, you will recognize the following steps.  This procedure for the tiny tooth resembles traditional root canal treatment.

5.   There will be careful removal of all the infected tissue from the root canals.  And keep in mind the root system of a baby tooth is not as developed as in a permanent tooth.

6.   After the clean-out of all the infected pulp, the dentist will disinfect the little root canal.  He will clean it, shape it and then fill the root canals to seal them.

7.   Here is an amazing step:  The dentist will choose an absorbable material with which to fill the now empty canals.  Thus, the body can still absorb the roots normally.  Then the tooth can be shed at the proper time, allowing the new permanent one to take its place.

What Replaces Pulp in a Pulpectomy?

Pulpectomy can be explained simply to allay a child's fear.

The Dentist Builds Confidence and Trust in Your Child Before pulpectomy.

To seal the roots of the tooth, dentists often use are zinc oxide/eugenol paste, or iodoform paste and calcium hydroxide. Research has also shown a mixture of calcium hydroxide and iodoform makes a perfect pulp replacement. The dentist can apply it easily.  Likewise, the body system can absorb it naturally.  Of course, this mixture is non-toxic to the prized successor teeth and is radio-opaque.  Radio-opaque means it has clear visibility on x-rays.

Silvery Crowns and Tooth Colored Hats

When the root canal treatment is complete, the dentist will choose a restoration for the tooth.  If the tooth is in the back, the choice is a strong stainless steel crown.  Front teeth require a composite, tooth-colored resin, for that natural look.

Primer:  Key Issues When your dentist recommends pulpectomy:

1.   Be sure you understand the procedure, the risks, and benefits of it.  Here at Children’s Dentistry, we will give you a full explanation of the situation and treatment alternatives.

2.   We encourage you to appear confident.  If you look worried, your child will be anxious. (We understand you might have had a poor experience with a previous root canal.  But this is a completely different situation.  Dental technology has progressed greatly in recent years.  At any rate, horror stories from you or siblings will only increase trepidation and anxiety in you or your child.)

3.   Be aware that painless dentistry involves local anesthesia.  We to numb the uncomfortable tooth.  The anesthesia will relieve your child’s pain, and clear the way for your dentist’s concentration.

No Fear of the Dentist Office or Pulpectomy

Happy Little Girl Recovers From Tooth Due to Pulpectomy

4.   As we mentioned above, “Your dentist will place a “rubber dam” on the tooth, or group of teeth.  This has several benefits.  First, it isolates the tooth.  Secondly, it creates a dry uncontaminated environment for the treatment.  It just looks a little weird to you, that’s all.

5.   The entire procedure includes a restoration of the tooth.  Thus, the restoration “bandages” the wounded tooth.  There will be no leakage.  We will also be protecting the beautiful tooth from further decay.

6.   We won’t desert you.  We recommend periodic visits so we can monitor the root canal treatment.   At Dentistry for Children, we believe follow up is vital.

Immature permanent teeth can also require endodontic treatment, but we will save that topic for a future blog.

A Touch of Dental Humor for Your Day:

Remember that as scary as “pulpectomy” sounds, it is a tried and true treatment which meets with a 90 percent success rate.  Today’s blog is a little serious.  So we thought we’d lighten the mood a bit by quoting an old Soupy Sales’ saying.

“Be true to your teeth and they won’t be false to you.”