Pulpotomy

What is a pulpotomy?

A pulpotomy is an endodontic procedure that restores a tooth by removing the pulp tissue in the crown affected by decay, infection or damage from trauma, before it reaches the root. By removing the pulp tissue before the decay, infection or damage has traveled deeper into the tooth’s structure, a pulpotomy can save a tooth from needing extraction or more involved treatments like a pulpectomy or root canal. Pulpotomies are most commonly performed on primary (baby) teeth but can also be effective for permanent teeth where there is enough healthy pulp and root structure remaining to maintain the tooth’s vitality.

Once the affected pulp is removed our doctors will apply a medication to protect the healthy pulp from being reinfected. Depending on the extent of the tooth structure removed, a filling or crown is then placed to fully seal the tooth, prevent harmful bacteria from entering, and provide structural support to withstand your biting forces.

How do I know if I need a pulpotomy?

X-ray images and diagnostic tests allow our doctors to assess the extent of decay or damage and the health of the surrounding pulp. Since the tooth’s nerves are in the pulp, you may experience pain and sensitivity to temperature if the pulp is affected, a condition known as pulpitis.

There are two types of pulpitis:

Reversible pulpitis: In the early stages once the cause is addressed and affected pulp is removed by a pulpotomy, the remaining pulp can be treated with medication and tooth sealed with a filling or crown.

Irreversible pulpitis: In more advanced stages, the pulp is too damaged to heal on its own and will eventually die. This requires a more involved procedure, such as a pulpectomy, root canal, or extraction, depending on the condition of the tooth’s structure.

What is the difference between a pulpotomy, pulpectomy and root canal therapy?

Pulpotomy

What: Partial removal of the pulp from the crown, medicinal application and sealing the tooth with a filling or a dental crown.

Why: To preserve the remaining healthy pulp, prevent reinfection and maintain tooth vitality.

When: Often used in primary (baby) teeth and sometimes in young permanent teeth.

Pulpectomy

What: Complete removal of the pulp from the crown and root, sterilization and medicinal application then sealing the tooth with a dental crown.

Why: Remove infected, damaged or dying/dead pulp and prevent reinfection that could make is necessary to extract the tooth.

When: Often used in primary (baby) teeth when the tooth structure is savable (does not need extraction), and sometimes permanent teeth to relieve pain when a root canal is unable to be completed until a later date.

Root Canal Therapy

What: Complete removal of the pulp from the crown and root of a tooth, followed by sterilization and filling the root canals with a sealing material and dental crown.

Why: Remove infected or damaged pulp, prevent reinfection, and the sealing material will also reinforce the tooth’s structure, preserving its function.

When: Most commonly used for permanent teeth and occasionally for primary (baby) teeth that have irreversible pulpitis or dead pulp tissue, and the tooth structure is saveable (does not need extraction).