Pulpitis is an infection that affects your dental pulp — which is the nerve found inside each of your teeth. Reversible pulpitis can be managed with conservative treatment involving medication. Irreversible pulpitis generally means a root canal (removal of the infected pulp) must be performed, as this can be the only solution for severely infected dental pulp in a permanent, adult tooth. So what happens when your child develops pulpitis in a baby tooth?
The Source of the Infection
The first task for the children's dental specialists at your local clinic will be to determine the severity of your child's pulpitis. The source of the infection will be traced. In many instances, pulpitis originates from a cavity or other deterioration in the tooth, which allows bacteria to reach the pulp chamber. The cavity will be filled, and if it's thought that your child's pulpitis hasn't yet become irreversible, antibiotics and careful monitoring of the situation may be sufficient.
Root Canal Treatment
In cases of irreversible pulpitis, a root canal may not be the most appropriate treatment for a baby tooth. A dentist must be cautious that any intervention doesn't disrupt the eventual eruption of your child's adult tooth. An adult tooth can remain perfectly stable after its pulp has been removed, but this is because its root structure is well-developed, allowing it to be permanent. Any measures which may affect the roots of a baby tooth can disturb dental exfoliation when the emerging adult tooth dissolves the roots of its baby predecessor.
Because of these potential concerns, irreversible pulpitis in a baby tooth is generally addressed by a procedure known as a pulpotomy. This can be thought of as a partial root canal. When the procedure is performed in an adult tooth, the inflamed pulp is removed from both the central pulp chamber, as well as the pulp canals at the base of the tooth, which lead to the tooth's roots. In a pulpotomy, the pulp canals are left intact.
The Tooth's Roots
In most cases, this approach is sufficient to eliminate the infection (and your child's discomfort), while not disturbing the tooth's roots—which won't disturb the impending exfoliation of the baby tooth. The empty pulp chamber will be irrigated and filled with a latex material. The tooth is then closed with a filling, although a dental crown is sometimes needed too. In baby teeth, this crown may be stainless steel, as opposed to the porcelain used in an adult dental crown.
So while a root canal isn't generally performed on a baby tooth, a pulpotomy is an efficient alternative that won't disrupt the development of your child's adult teeth. Contact a children's dental care specialist to learn more.