Dental Caries in Children And Pulpotomy

 Pulpotomy - Things to know about a pulpotomy

Children, as most parents know, may have many dental problems when growing up. We take pride in helping parents with their local kid's tooth questions and their kid’s toothache dental answers. We get asked many local pediatric dental questions online at DentalChat. We work with local dentists and local pediatric dentists to provide pediatric dental answers for people seeking pediatric dental answers to their kid's tooth problem questions

We get many Child Toothache Questions online such as My Kid’s Tooth Hurt Questions, My Child Has a Large tooth Cavity question online, Dental Pulp Treatment in the Primary Teeth Questions, and Is it better to save my kid’s baby tooth or Not? Parents are seeking children's tooth decay dental answers.


A common Children's Tooth Cavity Question would go something like, My Child has a large tooth cavity, what should I do?

Some children have rampant or many large teeth cavities. If your child’s tooth cavity is in the pulp nerve, and it is a very large cavity - then your child may be needing a pulpotomy? The common dental pulpotomy question is, what is Dental pulpotomy treatment? We get asked many dental pulpotomy questions online with us. Dental pulpotomy is a fairly common dental procedure for children and young adults with dental caries. This is a treatment that is done when dental caries reach the nerve or inside of the tooth pulp chamber. Pulpotomy can be done on both baby and adult teeth. Though, with adult teeth - will need to get full root canal treatment to complete. 

Children's dental trauma question?

What happens if my child has a severe tooth or tooth trauma question? A pulpotomy is also done when there is dental trauma that exposes the nerve chamber. There are very specific and well-defined guidelines as to when this procedure is appropriate. There are ways to avoid doing this procedure as it does not come without risk. 

Asking the right Tooth Cavity Question before dental treatment:

To get the right dental answers, it is good to ask the right children's dental questions of your family dentist. There are several well-documented significant infection outbreaks due to pulp treatment that have been reported in the literature. If a parent is told that their child needs a dental pulpotomy, this is the information that will provide them with the tooth cavity questions they need to ask the dental provider before consenting to these local children's dental care treatment. 

Enamel tooth layer and Sensitive dentin tooth layer 

Teeth have three layers. The outside enamel layer is designed to be in contact with the mouth and food. This is the defensive layer. It is a highly organized lattice of crystals. When exposed to acid and bacterial toxins, these crystals melt or disintegrate the same way ice would melt when exposed to heat. 

We get many dental questions about the second layer - the dentin tooth layer question, such as Why are my teeth sensitive questions? The second layer of the tooth is called the dentin, and it is nothing more than tubes that are filled with water that communicate back to the nerve cells. The third layer of the tooth is the pulp chamber. All teeth are hollow with nerves and blood supply on the inside. Immune responses happen to the inside of the tooth when the sterile environment is invaded.

The outside layer of the root of the tooth is called the cementum. The cementum is connected to the bone by the periodontal ligament. Beyond the cementum is the dentin, discussed above, and the nerve canal is filled with pulp tissue. 

Pulp Tooth Nerve 

The pulp tooth area is important to protect. We get asked many local pulpotomy tooth questions online. Our goal is to provide many local pulpotomy answers for our users at People want to know what they need to do when their kid has a large baby tooth cavity? 

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The pulp chamber is the inside of a tooth that is considered to be a protected and sterile environment. If this area is pierced due to dental caries/cavities, or tooth trauma - then the pulp tissue area must be managed to prevent further infection. In many ways, the roots of the teeth are like long straws that go deep into the bone. If the infection gets into the nerve chamber and progresses into the bone, it will cause a tooth abscess. 

Preventing Teeth Cavities 

A primary tooth question we get asked is how can we prevent dental cavities for our child? Many children seen by their pediatric dentist or family dentist, will have some form of dental sealants to protect the tooth or protect the teeth from caries. We do get quite a few dental sealant questions online. Common Dental Sealant Question is, how long will my kid's dental sealants last? This varies - but it should last for a year or longer.  Though, they may come out sooner due to a variety of reasons. 

 Tooth Cavity Question?

Common dental caries questions online include a tooth cavity filling question and my dentist says my child requires a pulpotomy question? Of course, there are always some children with dental caries or dental cavities. Ideally, your child will only require a simple composite filling to be done. A simple filling is fairly easy to do - especially if the cavity is small.

The dental treatment will go something like this usually. Your dentist will remove the caries or cavity with a drill, and then fill it with some sort of white filling (composite filling) If the nerve area of the baby tooth is involved, then your child may require a pulpotomy to be done. If a primary tooth has a cavity that is close to the nerve, or if there is trauma that approximates the nerve, the pulp tissue will have to be managed.  If a histological examination was done of the pulp tissue, significant inflammation would be seen in the area of caries or traumatic exposure. 

Any bleeding from the pulp tissue would need to be managed. An appropriate medication would be applied to the pulp tissue. And, a medication such as intermediate restorative material would be applied to achieve a seal of the pulp tissue. This would prevent bacteria from entering the nerve chamber. Ideally, the pulp tissue in the roots would remain vital.

 Importance of Dental X-rays 

Dental X-rays are an important part of dentists being able to diagnose what is going on, especially under the gums. A common dental X-ray question is, can I know without dental X-rays if I need a root canal? To evaluate a primary tooth for nerve treatment, a dental radiograph must be evaluated.

These primary teeth are very porous, and toxins can leak out of the nerve chamber causing bone resorption between the roots of a molar or at the tip of the roots. If there is an infection that has leaked at the apex or in the furcation, extraction of the primary tooth is indicated. If the supporting structures are in great shape, a pulpotomy would be indicated.

Ask Dentists Questions and Get the Best Local Dentist Answers with us at DentalChat. Ask a Dentist a Local Tooth Cavity Question - simply post your children’s dental questions to get the best local dentists' answers online. 

Tooth Pulpotomy QuestionAnswer, And Treatment

A common local tooth pulpotomy treatment question we get asked is, how is tooth pulpotomy done on a primary baby tooth? The pediatric dental pulpotomy has always been done by removing all of the pulp tissue within the crown of the tooth. This tissue is removed until the top of the roots are visualized.

Then the tissue is either cauterized, or a medicine such as formoterol, ferric sulfate, or multiple other medications have been applied to cause the bleeding at the tops of the roots to stop. The chamber is then filled with a material that can absorb any kind of water or fluid that leaks out of the roots. This is usually intermediate restorative material or IRM.

  This filling material must also seal to prevent bacteria from getting into the roots. A dental restoration is placed above the nerve treatment.  Regardless of what kind of medication has been applied to the top of the pulp tissue in the roots, success rates have been pretty similar over the years. This has been deemed the standard of care if a cavity gets into the nerve or if there is trauma to the nerve. Follow-up is done with radiographs and monitoring for symptoms.  A Local Pulpotomy Question Asked Online by some Parents is, how do we know the pulpotomy worked? The pulpotomy is deemed successful if the primary tooth is kept until it would normally exfoliate.

Also, if there is no tooth pain & if there was some infection - has been alleviated. Good idea to do a follow-up with your local dentist to make sure everything has gone well after the dental treatment.  

 Children’s Large Dental Caries 

Usually, your child with a small cavity will NOT need a pulpotomy. If your child or youngster has a large amount of dental caries in the mouth, then they may require a pulpotomy.

Dental Water Irrigation 

There has been an update to this process over the last couple of years. Water was used to irrigate before placing the medicine in the tops on top of the roots. This water used needs to be sterile. This was not known in the past. All of the water we get out of our taps has very low levels of bacteria and micro bacteria. As long as these levels are at an acceptable level, the water has no negative effects on our health. However, a few years ago a nasty microbacterium called microbacterium abscess rose to levels then were unsafe in some water supplies. 

One of the first documented dental clinics to have had such an issue was south of Atlanta, Georgia. The tap water contained high levels of this bacteria. This caused close to 25 children to get a micro bacteria infection in their jaw bones which required the removal of a large amount of bone surgically. The only antibiotic that was identified to treat this infection is called amikacin, and a side effect is that will cause hearing loss. This outbreak was well-managed, and very few children had any long-term negative effects. A few months later, there was a very large outbreak in Anaheim, California of about 55 children who had the same kind of infection.

These outbreaks of infection caused everybody to rethink pulpotomy treatments. There is some question in the literature about if the iron in the Ferric Sulfate may cause the micro bacteria to grow. This would stimulate bad bacteria to proliferate and cause jaw bone infections.

There is also evidence in the literature that if the dentist stops drilling before entering into the pulp, and places a material to protect the pulp, pulpotomy treatment may not be indicated. Success rates for this kind of treatment are high, and research is ongoing. The goal now is for the dentist to stay out of the pump chamber if it is at all possible when restoring teeth with dental cavities or dental trauma. 

Primary Tooth Extraction And Baby Tooth Extraction Treatment Option

We get asked many parents a fairly common kid tooth extraction question?  The baby tooth extraction question many parents ask is, should we keep the baby tooth with a pulpotomy or should we extract it? It is very reasonable for a parent to decide they do not want to do a pulp treatment and would rather have a primary tooth extracted. Especially if the baby tooth is close to the age of falling out. Microbacteria infections are very serious and very rare. But, they do exist. Pulpotomy treatments must be done with sterile water. And, they require radiographic and clinical follow-up. As we have stated, most baby teeth fall out sometime before the mid-teen years (there are always some rare exceptions - you should check with your local dentist and do dental x-rays).

Some baby teeth extraction reasons - Pulpotomy goal is to maintain the baby tooth longer:

Baby teeth will usually all eventually fall out. On a side note, there are some people in their twenties that still have one or more of their baby teeth - though, this is fairly rare. Since baby teeth do fall out, a common baby teeth question we get asked is, why save the baby tooth? Because, if you start extracting a tooth way before it is loose for your child, then they can have teeth shifting and also your kids do need teeth to chew with. You do not want to take out a baby tooth 3 years earlier than it should if you can possibly save it with a pulpotomy.

The goal of all these heroic dental treatments is to be able to maintain the primary tooth until its normal time of exfoliation. This is done for aesthetics and function, and to prevent space loss. If your child has dental disease or dental trauma which grows into the pulp, an in-depth conversation is necessary with your dental provider. A very detailed conversation is necessary with your dental provider to decide which treatment options are appropriate for your child. If your baby tooth is usually going to be falling out around the age of 8 or 9, and your child is 7 ½ years old - with a large baby tooth cavity, then maybe extracting or taking out the baby tooth may be a good idea …. After your local family dentist or pediatric dentist does a full dental exam and evaluates the dental x-rays.

Pediatric TeleDental Question - Parent Children TeleDentistry Answers?  

Just like telemedicine, parents can now use Children Dental TeleDentistry Consulting for some basic baby tooth tel dental questions. Local Dentist On-Demand TeleDentistry is now being offered by more local dental practices for the parents of children.  

Helping their dental patients online -Local Dentists Chat Bot / Pediatric Dental Offices Using Smart Dental ChatBots:

Local Dentists can help their patients by adding a smart Local Dental ChatBot to their dental website. Dentists during COVID can use Local TeleDentistry and become the Best TeleDental Office in their area. Better Local Dental Office Messaging between dental offices and dental patients. Patients can ask if their local dental office provides a Local TeleDentist service? Add TeleDentistry to your local dental office. and DentalChat app are helping local dentists and dental patients better connect.

Have a Baby Tooth Question?

As we discussed in this local baby tooth treatment blog, saving baby teeth until they are loose and ready to come out is a good idea. Going to your local pediatric dentist or family dentist can help in getting the right dental treatment for your child. Baby Teeth Dental Answers with us. We get asked many Local Children Dental Questions Online. This may include a Baby Tooth Problem Question, Baby Tooth Pain Questions, and Getting an Online Pulpotomy Answer.

We provide dental information - that may be helpful for you and your family. Always do your own dental research, to help your kids with their teeth. Getting regular dental checkups at your local dentist is a great way to help with your child’s dental care. We provide local children's dental care answers to your children's dental care questions - We welcome our user's feedback and dental suggestions. 

What is the difference between a pulpotomy and a root canal?

We get asked many root canal questions online at DentalChat. A common root canal question is, is a pulpotomy and root canal the same?  The root canal answer is no.  A pulpotomy can be done on an adult tooth, but that is only the first stage -- to get someone out of pain. The root area of the tooth will need full root canal treatment.  For baby teeth, there is no fully developed root canal area to do a root canal. Hence, only the pulp area of the tooth is cleaned out and filled.