These procedures are used to try to save decayed teeth with inflamed or infected pulps.  The difference is only in the amount of pulp to be removed:  Partial removal is a pulpotomy, and full removal is a pulpectomy (root canal treatment).  In adult teeth a pulpotomy is referred to as a partial root canal and is usually provided during an urgent care appointment to relieve pain.

The pulp of a tooth is made up of soft tissue containing blood vessels, nerves, and pink connective tissue.  It extends from the crown (under the enamel and dentin layers) down to the bottom of the root.  The pulp can’t heal by itself, so if pulp tissue becomes inflamed and/or infected, a pulpotomy to remove the diseased portion is done and medication is applied to keep the remaining pulp healthy.  A permanent tooth can survive nicely without the pulp and nerve, because the tooth continues to be nourished by the tissues surrounding it.

A pulpotomy (sometimes called a baby tooth root canal) is most often performed in young children, but only when the affected pulp is confined to the crown, and the soft tissue in the canals is still healthy.  The most common causes of pulp problems are tooth decay that reaches the pulp or trauma that exposes the pulp.  If the inflammation and infection is left untreated, it is very likely that the tooth will eventually abscess.  That can lead to bone loss and problems with permanent teeth in the formative stage.

Baby teeth are just as prone to cavities as adult teeth, and have relatively large pulp spaces, so a cavity does not have to get very large before it penetrates the pulp chamber.  Also, baby teeth are not as hard or as strong as adult teeth, and the nerve inside a baby tooth is closer to the outside, which is why children with primary teeth are often more sensitive and susceptible to decay and tooth pain.

When the soft tissue in the pulp chamber is infected (has bacteria in it) or affected (is inflamed), it can be removed by a dentist under local anesthetic. The dentist will usually use a spoon excavator tool (alternatives are electro-surgery or laser), and then place a disinfecting agent, which also calms the remaining nerve tissue, into the chamber in an attempt to keep the remaining pulp (in the canals) alive.  It is then sealed with a filling or often a stainless steel crown to protect the baby tooth until the permanent tooth comes in.

Why treat baby teeth that are going to fall out anyhow?

  • They help children chew food easily and properly
  • They help children speak more quickly and clearly
  • They hold space in the jaws for permanent teeth that are growing under the gums
  • They set the stage for a lifetime of healthy smiles

More than 50 percent of children will be affected by tooth decay before the age five, so it’s important to avoid cavities by exercising proper oral hygiene to prevent an early loss of a tooth. When a baby tooth is lost too early, the permanent teeth can drift into the empty space and make it difficult for other adult teeth to find room when it’s their turn to erupt.

The pulpotomy is a routine procedure that is very common, and can often be completed at the same time as other dental treatments such as fillings, which minimizes the number of times your child needs to return to the dentist chair.  Bottom line: a pulpotomy is a really good and reliable way to save a badly decayed baby tooth.

If you are interested in pulpotomy in Costa Rica, fill out the “Find a Dentist” form on this page.  One of our patient advocates will reply to your needs.