In medical terms, debridement is the removal of damaged tissue and/or foreign objects from a wound.  In dentistry pulpal debridement, also referred to as a pulpectomy or partial root canal, is an endodontic treatment for the removal of diseased or damaged pulp tissue, the soft area at the center of a tooth which contains the blood vessels, nerves, and pink connective tissue.

Pulpal debridement is the first step of a root canal treatment where all of the pulp tissue is removed, or in the case of a partial root canal, it is done before a complete root canal treatment can be completed, in order to relieve serious pain caused by swelling from an infection of the dental pulp and nerve.  This relieves pressure and pain by providing room for the dental pulp to expand.  However, the complete root canal treatment must still be done, can be, and almost always is done in one visit, because a root canal is the only way to save the tooth.

These are some of the symptoms your dental pulp may be infected or damaged:

  • Severe toothache
  • Tooth sensitivity to hot or cold temperatures
  • Darkening of a tooth
  • A loose tooth
  • Swelling or pain in the gums
  • A recurring pimple on the gums

When decay penetrates through the tooth enamel and dentin, and into the sensitive inner portion of the tooth where the nerve is, it causes the area to swell and become inflamed. That is when most patients begin to experience severe pain and pressure, especially when biting and chewing.

The goal of pulpal debridement in a partial is to maintain the health of the tooth for as long as possible if there must be a delay before completing the root canal treatment.  In the case of baby/primary teeth, however, the tooth needs the pulp with nerve and blood vessels to develop, and the tooth needs to be preserved to have successful development of permanent teeth.  Removing just the diseased portion of the pulp is called a pulpotomy.

Some of the reasons the dental pulp can become inflamed or infected are:

  • Deep tooth decay
  • Multiple dental procedures on the tooth
  • A large dental filling
  • A chip or crack in the tooth
  • Facial trauma

In the debridement portion of a root canal treatment, a small opening is made in your tooth to remove the dental pulp from the tooth’s core, and the canals inside the roots are cleaned with files of increasing diameter and debris flushed out, disinfected (and medicated if needed), and then its walls filed and flared to eliminate bacteria.

 

The steps for endodontic, i.e. root canal, treatments are:

  1. Diagnosis: The most important aspect is a correct diagnosis.
  2. Access: Creating an opening to the pulp chamber.
  3. Extirpation: Removing the pulp tissue and nerve.
  4. Debridement: Thoroughly cleaning and disinfecting of the canals.
  5. Drying: Important to ensure a successful seal and keep bacteria out.
  6. Obturating: Filling the empty cleaned and disinfected cavity, usually with gutta percha.
  7. Restoration: Placing the final filling or crown.

If a root canal is started but not completed, the tooth will likely become a source of pain and infection, and will eventually cause many problems, including a risk that the tooth can fracture or cause a potentially dangerous swelling of the gum.  If the tooth has become fractured or is badly decayed, it may need to be removed.  There are really no good reasons why a root canal should be left unfinished.

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