In the Know for You to Know

As pediatric dentists we are always emphasizing good oral habits like brushing and flossing. You’ve heard it so often you can recite it in your sleep.
The reason we talk about this so much is because often times when a cavity forms it doesn’t stay small for very long. It grows and its continuing growth is what makes it concerning.
You see, a tooth is made up of several layers, actually 3 distinct layers. The 1st is the outside layer, the enamel which is the hardest layer. Once a cavity (aka decay) penetrates through the enamel it moves into the 2nd layer which is the dentin.
The dentin is the middle layer and is softer than enamel so the cavity readily moves through this part. Once the cavity expands past the dentin it invades into the 3rd layer which is the nerve (aka pulp) of the tooth.
The pulp is the deepest layer of the tooth and has the blood supply and nutrients that the tooth needs but the cavity bacteria thrive on and want.
When a cavity invades into the pulp it causes the pulp to become inflamed, which can lead to a toothache and sometimes an infection.
There is a specialized procedure that is done specifically for when the cavity has reached the pulp in order to save the tooth, and this is called a Pulpotomy.
Today we’re breaking down the basics on when your child’s cavity has gotten so deep that a Pulpotomy is indicated.
What Is A Pulpotomy?
A lot of pediatric dentists refer to a pulpotomy as a “baby root canal.” While a root canal for adult teeth is a much different procedure, the basic reason is the same.
In a pulpotomy the inflamed portion of the pulp is removed and a specific medicated solution is used to treat any remaining bacteria in the pulp area.
The overall purpose of a pulpotomy is to preserve your child’s dental health.
Why Does My Child Need A Pulpotomy?
As a parent recognizing the signs at home indicating the need for a pulpotomy for your child is crucial.
Symptoms and complaints of a severe or ongoing toothache, tooth sensitivity especially when eating, tooth discoloration, waking up in pain during the night, or difficulty chewing indicate you need to contact your pediatric dentist.
By addressing these issues early on, you can help prevent the spread of infection and preserve the overall health of your child’s teeth and gums.
In contrast, hoping these red flags will go away can lead to more serious sequela.

Why A Pulpotomy And Not A Regular Filling?
A pulpotomy is the treatment of choice for a tooth when the cavity is so deep that it has infiltrated into the pulp of the tooth.
Once the cavity has gotten to the point when it extends into the pulp it is quite large. Since the cavity is extremely large and deep a traditional filling doesn’t address the nerve involvement, and can make things worse.
How Is A Pulpotomy Performed?
A pulpotomy is typically performed by removing the inflamed tooth pulp, with local dental anesthesia (aka numbing the tooth).
Once the tooth is numb, the dentist carefully accesses the pulp chamber and removes the inflamed or infected pulp tissue. This aims to eliminate the source of the infection and prevent it from spreading further.
After the pulp is removed, a medicated solution and dressing is placed into the pulp chamber to promote healing and help prevent bacterial growth.
What Do You Need To Know For After A Pulpotomy?
After treatment, the pain of your child’s toothache will go away.
Once the numbness wears off, their tooth may feel a sore for a day or two, but not like the pain they had before the pulpotomy.
The best part is you and your child can get back to your normal routine.
What To Remember
There are 2 goals for why a pulpotomy is performed —
The 1st is to take your child out of pain and preserve your child’s dental health,
The 2nd is to restore their tooth’s function and maintain its structural integrity.
Both are important for preserving your child’s tooth for the long term.
Has your child ever had a toothache? One that kept them up at night? and painful enough they didn’t want ice cream or candy? What did you do? Tell us, We’d really like to know! Send us an email at kidstoothhotline@proton.me Like Us or Chat with us at facebook.com/kidstoothhotline
More tips? We have lots. We’re here just for kids!
