Restorative Dental Procedures

Dental Steel crownA pulpotomy is when the inflamed pulp chamber, usually on a baby molar, is removed, the area is sterilized, and the chamber is sealed. It is sometimes called a baby tooth root canal, but it’s not really a root canal and it can be done is some cases in permanent teeth. It is a very common procedure in children and has a reasonably good prognosis of success. It’s also fairly easy to do in conjunction with associated procedures.

When a cavity gets really deep, close to the pulp of a tooth or even into the pulp, the pulpal tissue becomes irritated and inflamed. This is usually the “tooth ache” you feel. If the inflammation and infection continues without treatment, the tooth will likely eventually abscess.

In baby molars, a pulpotomy is used in the process of trying to save and restore the tooth. First, the decay is removed, and then the pulp chamber (the top part, not the root canals) is removed usually with a high-speed bur or spoon excavator. A small cotton ball damp with formocresol is placed to “mummify” the pulp stumps and to sterilize the area.

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After a couple of minutes, the cotton ball is removed and the opening is sealed usually with a Zinc Oxide and Eugenol material like IRM. IRM is a putty like material that hardens up after a few minutes. After a pulpotomy on a baby molar, it is usually necessary to place a stainless steel crown to restore the tooth.  The stainless steel crown is just a standard size crown that is cemented over the tooth.  The reason that this is necessary is because the tooth no longer has a blood supply and is very brittle.  Also most of the tooth is gone and the restoration would be so large that it would probably break before the tooth is suppose to be lost.  It is just better to do the crown to begin with and then the tooth is stable until it exfoliates or is lost at normal age.  The tooth will come out with the crown on it.