Children’s teeth can become decayed and infected and if the decay has progressed quite far into the tooth, you might find we suggest a root canal treatment. These are quite different from adult root canal treatments, taking into account the developing tooth as well as the immature adult tooth that lies directly underneath. The different types of treatment include:
Indirect Pulp Treatment
An indirect pulp treatment is used for teeth where the decay hasn’t quite reached the pulp, right in the center of the tooth. The pulp contains all the nerves and blood vessels to the tooth and when it becomes infected it can be very painful. During this treatment a pediatric dentist will remove all the decayed softer parts of the tooth, without penetrating the pulp. Next, an inner layer of special cement will be placed over the exposed dentin which lies just underneath the tooth enamel. This helps sterilize the surrounding dentin, reducing infection and inflammation and reducing the acidity caused by tooth decay, prompting the tooth to produce reactionary dentin which helps to protect the tooth. The tooth is then permanently filled at a later date when all the infection has been proven to be removed. This type of treatment can be very successful, helping to save milk teeth until they are ready to fall out naturally.
A pulpotomy is a procedure to partially remove the pulp. It is tried and tested and has a success rate of around 90%. The pediatric dentists use this procedure to treat cases where the pulp is exposed as a result of tooth decay and where the infection and inflammation is confined just to the area of the pulp in the tooth crown. The procedure involves removing the portion of the pulp just inside the crown of the tooth, leaving the root canals that extend into the tooth roots untouched and intact. The reason for this is to help preserve the vitality of the tooth until the adult tooth is ready to come through at which point the tooth will be lost naturally. Various medications and compounds are used to help promote healing, in particular encouraging new dentin to form so the tooth can heal itself to a certain extent.
This is where all the infected pulp tissue will need to be removed due to infection and because it is likely to be extremely painful. Often the pain is accompanied by swollen gum tissues or even a swollen cheek. This procedure resembles a traditional root canal treatment, removing all the infected tissues from deep in the root canals. The filling material used to seal up milk teeth is slightly different to adult teeth as it needs to be easily reabsorbed by the body. This is because the tooth roots of a milk tooth are gradually reabsorbed as the adult tooth gets ready to come through. Once the pulpectomy is complete, the tooth is restored with a crown.