Dental pulp is found inside every tooth. It’s the soft, sensitive part of the tooth that houses nerve endings and veins, keeps blood circulating through the tooth, and helps you detect temperature.
In some cases, this soft tissue can become infected. When this happens to children, the problem is solved with a pulpectomy. The procedure can be done on adults as well, but it’s more commonly performed on children as it’s less invasive than other, similar treatments.
What is a Dental Pulpectomy?
A dental pulpectomy removes infected or damaged pulp, which can help to save the tooth. Pulpectomy treatment is often done on children who have baby teeth with severe infections. Removing the infected pulp allows your dentist to alleviate pain and prevent the infection from spreading. Pulpectomies are common procedures done by paediatric dentists or general dentists with experience in treating children.
Why Perform a Pulpectomy?
Prevent Infection from Spreading
Infections in the tooth pulp can cause severe pain and discomfort, but they can also spread to surrounding tissue. Pulpectomies remove the infected pulp to prevent the infection from spreading to other teeth or the jawbone.
Pain Relief
Toothaches caused by infected or inflamed pulp can be excruciating. Pulpectomies provide immediate relief from this pain by removing the source of the infection. By addressing the pain quickly, you can avoid further complications and improve your child’s quality of life.
Preserve Tooth Structure
Preserving the natural tooth structure is always first prize. A pulpectomy helps preserve the outer structure of the tooth while removing the damaged inner pulp. This prevents the need for more invasive procedures, like extractions, and maintains the integrity of the tooth for future restorative treatments.
Proper Chewing Function
Healthy teeth are essential for proper chewing and digestion. When a tooth is infected or damaged, it can affect your child’s ability to chew food effectively. A balanced diet is vital for overall health, and pulpectomies help restore the function of the affected tooth. This allows your child to continue enjoying a varied and nutritious diet without discomfort.
Maintains Spacing for Permanent Teeth
Maintaining the spacing of children’s primary teeth is a must. Improper spacing can lead to complications when permanent teeth begin to erupt. Early tooth loss due to decay or infection can lead to misalignment and orthodontic problems later in life. A pulpectomy in primary teeth can keep your child’s teeth properly spaced and help to maintain their oral health.
Signs Your Child Might Need a Pulpectomy
Persistent Toothache
A persistent toothache is one of the most common signs that your child may need a pulpectomy. This type of pain is often continuous and doesn’t go away with standard pain relief methods. It might be worse at night or when your child is eating.
Sensitivity to Hot and Cold
Sensitivity that causes sharp pain or discomfort might be a sign of pulp damage. This happens when the protective layers of the tooth are compromised, which allows external stimuli to irritate the nerves inside. It’s important to monitor this symptom and consult with a dentist to determine the best course of action.
Swollen or Red Gums
Swelling or redness in the gums around a particular tooth can be a warning sign of infection. In some cases, you might also notice a small bump or pimple on the gums, known as a dental abscess. This can be particularly concerning as it indicates that the infection is spreading beyond the tooth itself. Immediate dental treatment is necessary to prevent further complications and alleviate discomfort.
Sudden Tooth Discolouration
A tooth that suddenly changes colour, especially if it turns dark or grey, may indicate that the tooth’s pulp is damaged or dead. This discolouration is usually a result of trauma to the tooth or severe decay reaching the pulp chamber.
Unexpected Loose Tooth
If a permanent tooth becomes loose without any apparent injury or trauma, it could be a sign of severe infection or advanced decay affecting the tooth’s supporting structures. In children, this is particularly concerning as it can influence their dental alignment. A pulpectomy might be necessary to treat the infection, stabilise the tooth, and prevent further dental issues.
Pulpectomy Procedure: What to Expect
Understanding the steps involved helps you to prepare your child so they feel more comfortable during the procedure. Here’s how a pulpectomy procedure works:
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Anaesthesia to Numb the Area
The first step in a pulpectomy is administering local anaesthetic to numb the affected area, so your child doesn’t feel any pain during the procedure. Your dentist will inject the anaesthetic around the tooth and surrounding gum tissue, and wait for a few minutes for it to take effect. Patients may feel a slight pinch during the injection, but the numbing effect quickly sets in.
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Removing Infected or Damaged Pulp
Once the area is numb, your dentist will create an opening in the crown of the tooth to access the pulp chamber and root canal system. Using specialised dental instruments, your dentist removes the infected or damaged pulp tissue. Patients might feel some pressure during this process, but the anaesthesia prevents any pain.
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Cleaning and Disinfecting the Tooth Interior
After the pulp is removed, your dentist thoroughly cleans the inside of the tooth. This involves using files and irrigation solutions to scrub the walls of the root canals and flush out any remaining debris and bacteria.
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Filling Root Canals with Biocompatible Material
Once the tooth interior is clean and disinfected, your dentist will fill the root canals with a biocompatible material. The most commonly used material is gutta-percha, a rubber-like substance that’s safe and effective. This filling helps maintain the structure of the tooth and supports its function. Your dentist may also place medication inside the tooth to promote healing and prevent future infections.
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Sealing the Tooth
The final step in a pulpectomy is sealing the tooth. The dentist will place a temporary or permanent filling over the opening made in the crown. In some cases, especially for children, a stainless steel crown might be placed to protect the tooth and restore its normal function. This seal prevents bacteria from re-entering the tooth and ensures the long-term success of the treatment.
Caring for Your Child After a Pulpectomy
After the procedure, your child may experience some discomfort and sensitivity. It’s important to follow the dentist’s aftercare instructions carefully for a smooth recovery. Here are some extra tips to help your child recover faster.
Avoid Chewing on the Treated Side
To prevent further discomfort and protect the treated tooth, encourage your child to avoid chewing on the side where the pulpectomy was performed. Soft foods such as yoghurt, mashed potatoes, and soups are ideal for the first few days.
Avoid giving your child hard, crunchy, or sticky foods that could irritate the area. Keep the treated side free from excessive pressure so the tooth heal faster. This will also reduce the risk of complications.
Maintain Good Oral Hygiene
Good oral hygiene is even more important after a pulpectomy. Encourage your child to brush and floss their teeth gently twice a day. Moreover, using fluoride toothpaste can help protect the teeth from further decay. Remember to use a soft-bristled toothbrush.
Be cautious around the treated tooth, and remind your child to rinse their mouth with warm salt water to soothe any soreness. Flossing should continue as usual, but be gentle near the affected area.
Regular Dental Check-Ups
Schedule follow-up appointments with your child’s dentist as recommended. These visits allow the dentist to check for any signs of infection or complications and provide further care if needed.
Is it possible for Complications during Dental Pulpectomy Procedure?
Damage to the Permanent Tooth
There’s a small risk of damaging the developing permanent tooth underneath if the procedure is not performed with precision. Dental practitioners are highly trained and follow strict guidelines to minimise this risk. However, complications can still happen.
Damage might include the disruption of the permanent tooth’s development or alignment issues. Parents need to follow up with regular dental check-ups to monitor the health and development of their child’s teeth post-procedure.
Infection If Not Properly Sealed
If the pulpectomy is not properly sealed, there’s a risk of infection if bacteria enters the treated area. This can lead to further decay and an abscess may develop.
Dentists use high-quality materials and techniques to seal the tooth, but infections can still happen, particularly if the tooth is not cared for properly at home. Signs of infection include pain, swelling, or a persistent bad taste in the mouth.
How much does a Pulpectomy Cost?
The average cost of a pulpectomy in Australia can range between $500 and $1,500 per tooth. Here’s a more detailed breakdown:
- Initial Consultation and X-rays: Before a pulpectomy, you’ll need an initial consultation and X-rays to assess the condition of the tooth. This can cost between $100 and $200.
- Pulpectomy Procedure: The main procedure itself can cost between $400 and $1,000. This includes removing the infected pulp and sealing the tooth.
- Follow-up Appointments: Follow-up visits may be necessary to make sure the tooth is healing properly. These cost between $50 and $150 per visit.
Factors Affecting the Cost of a Pulpectomy
Several factors influence the cost of a pulpectomy. These include:
- Location: Dental services in metropolitan areas like Sydney and Melbourne may be more expensive compared to regional or rural areas.
- Dentist’s Experience: Highly experienced or specialist dentists might charge more for their services.
- Complexity of the Procedure: The condition of the tooth and the extent of the infection can affect the procedure’s complexity and cost.
- Dental Clinic Fees: Different clinics have varying fee structures, which can impact the overall cost.
- Insurance Coverage: The type and extent of dental insurance coverage can significantly reduce out-of-pocket expenses for patients.
Dental Pulpectomy for Primary Teeth FAQs
What’s the Difference Between a Pulpotomy and a Pulpectomy?
A pulpectomy is a more extensive dental procedure than a pulpotomy. During a pulpotomy, the dentist only removes the infected or inflamed pulp from the crown of the tooth. The remaining healthy pulp in the root canals is left intact. The tooth is then sealed with a special medicated filling, and sometimes a crown is placed on top for added protection.
A pulpectomy removes of all the pulp tissue from both the crown and the root canals of the tooth. This procedure is necessary when the infection or tooth decay has spread through the entire pulp, including the root canals.
What’s the Difference Between a Pulpectomy and a Root Canal Procedure?
A root canal begins with a pulpectomy, after which the dentist cleans and shapes the root canals, and then fills them with a rubber-like material called gutta-percha. The tooth is then restored with a crown or filling to return it to its full function.
If you found this article interesting, you may also be interested in learning about when baby teeth start to fall out.
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