Inflamed Dental Pulp in Your Child's Tooth: Will They Need a Root Canal?

Pulpitis is an inflammation of the dental pulp (the tooth's nerve). When your dentist informs you that you're experiencing pulpitis, the next step is determining if the condition is reversible (meaning that the pulp will recover) or irreversible (meaning that the pulp must be removed with root canal treatment). However, with primary, baby teeth, dentistry has another option for children who are experiencing pulpitis. 

Your Child's Dental Pulp

If your child's tooth has undergone significant decay or has been damaged in an accident, the dental pulp is no longer securely contained within its pulp chamber. Decay or other dental trauma can allow bacteria and other contaminants to make direct contact with the pulp, which has led to its inflammation. Even when this inflammation is irreversible, your child won't necessarily need root canal treatment.

Severing the Pulp

A pulpotomy is when a dentist opens the tooth to expose its pulp. The coronal pulp (the section above the gum line) is then severed and extracted, leaving the tooth's root system intact. A pulpotomy is the preferred course of action with a primary tooth, as it doesn't disrupt dental exfoliation. This is when the development and upward eruption of the replacement adult tooth dissolves the root structure of the primary tooth, which then loosens and is lost. It's in your child's best interests to leave their tooth's root structure intact for the purposes of dental exfoliation.

Filling the Pulp Chamber

It's not as though the tooth's pulp chamber can be left empty. This would weaken the tooth, making it more prone to breakage, which defeats the purpose of keeping the tooth in as natural a state as possible via a pulpotomy. Gutta-percha (a form of biocompatible latex) is typically used to fill a pulp chamber following root canal treatment, and this is an option. With a pulpotomy, your child's dentist may opt to use a mineral trioxide aggregate, which mimics the density and consistency of the rest of the tooth. 

Finishing the Tooth

After its pulp chamber has been addressed, the tooth will be sealed with a filling, but may also require a dental crown to reinforce the tooth. Stainless steel dental crowns are common in children's dentistry and may be the recommendation when the tooth in question is a molar (so it's not especially conspicuous). Anterior teeth (which are prominent when your child smiles) may be better off with a natural-looking paediatric zirconia ceramic crown, which are pre-made, and so are less expensive than an adult dental crown.  

Although modern dentistry has made advances that ensure that a root canal is an uncomplicated and painless procedure, you will probably want to spare your child from the procedure if it can be avoided. With a less-invasive pulpotomy, a root canal can be avoided.

Contact a dentist for more information. 

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