Your guide to the pulpectomy procedure

Children can find themselves with infected teeth after having large cavities, tooth decay or dental trauma. In these cases, the pulp inside their teeth may need to be removed via a dental procedure called a ‘pulpectomy’. Dr Camen Colomar, a paediatric dentist and member of Dr Moira Wong’s highly experienced team, regular performs pulpectomies in Dr Wong’s clinic, and here she provides answers to the most common questions regarding pulpectomies.

What is a pulpectomy?

During a pulpectomy, a dentist will remove the pulp from inside the crown and root of a child’s tooth.

This dental treatment is required when the pulp becomes infected. Usually, infection occurs when children have large cavities and decay. It can also be required when children receive dental trauma, such as after a fall or any type of hard impact.

While pulpectomy procedures are common in children with cavities, they are not common in children who receive regular dental check-ups, have low sugar diets and maintain good dental hygiene.

Who is the treatment for?

A pulpectomy is for children who have infected baby teeth – which can also be referred to as deciduous teeth or milk teeth.

A pulpectomy can be used, in theory, for both baby and adult teeth. However, dentists use the term “pulpectomy” to refer to treatment on a baby tooth. A similar procedure, the root canal, is usually used to refer to the procedure on adult teeth – which is slightly different.

Is a pulpectomy the same as a root canal?

Both the pulpectomy and root canal have the same principle. In both, the dentist will clean the canal of the tooth’s root to clear the infection.

However, when a dentist performs a root canal (in an adult tooth), they will place a new permanent filling inside the canal to replace the root. The dentist will want it to never dissolve with time. On the contrary, a dentist won’t place a permanent new filling during a pulpectomy (in a baby tooth) because the new adult tooth underneath usually absorbs the root from the recently lost baby tooth. After a child has a pulpectomy, the new non-permanent filling will fall out with the baby tooth.

What happens during treatment?

Before the treatment begins, a local anaesthetic is injected around the tooth that will be worked on. The child won’t feel pain and might be drowsy.

Firstly, the pulp inside the tooth is removed with special files. Following this, the tooth is disinfected, washed, dried and filled. Lastly, it is filled with a re-absorbable material.

After the treatment, the tooth can be a bit tender because the dentist has cleaned around the tooth. The infection should clear quickly and there should be no need for medical pain relief.

Generally, the procedure takes 30-45 minutes.

Why not just remove the teeth?

Most of the time it’s important to keep the baby tooth. An exception is if the baby tooth is about to fall out and the permanent adult tooth is due to erupt and grow in soon.

Furthermore, the extraction of a baby tooth can negatively impact the growth of the permanent tooth. When it’s lost early, the adjacent teeth can shift into the space that has been left, leaving the new tooth without a clear pathway to erupt.

Can you avoid a pulpectomy?

In cases of infections caused by cavities, these can be avoided by ensuring your child has regular dental check-ups and maintains good dental hygiene. If an infection occurs, a pulpectomy can be avoided by diagnosing infection in the early stages. An alternative to the procedure is to extract the tooth, but as previously mentioned, this is often not the best treatment in the long term.

Visit Dr Wong’s Top Doctors profile to find out how she and her highly skilled team at Moira Wong Orthodontics can care for your family’s orthodontic needs, including a pulpectomy should your child need one.