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What is Pulp Therapy?

The “pulp” of a tooth cannot be seen with the naked eye. Pulp is found at the center of each tooth, and is comprised of nerves, tissue, and many blood vessels, which work to channel vital nutrients and oxygen.  There are several ways in which pulp can be damaged.  Most commonly in children, tooth decay or traumatic injury lead to painful pulp exposure and inflammation.

Pediatric pulp therapy is known by several other names, including: root canal, pulpotomy, pulpectomy, and nerve treatment.  The primary goal of pulp therapy is to treat, restore, and save the affected tooth.

Pediatric dentists perform pulp therapy on both primary (baby) teeth and permanent teeth.  Though primary teeth are eventually shed, they are needed for speech production, proper chewing, and to guide the proper alignment and spacing of permanent teeth.

What are the signs of pulp injury and infection?

Inflamed or injured pulp is exceptionally painful.  Even if the source of the pain isn’t visible, it will quickly become obvious that the child needs to see the pediatric dentist.

Here are some of the other signs to look for:

  • Constant unexplained pain.
  • Nighttime pain.
  • Sensitivity to warm and cool food temperatures.
  • Swelling or redness around the affected tooth.
  • Unexpected looseness or mobility of the affected tooth.

When should a child undergo pulp therapy?

Every situation is unique.  The pediatric dentist assesses the age of the child, the positioning of the tooth, and the general health of the child before making a recommendation to extract the tooth or to save it via pulp therapy.

Some of the undesirable consequences of prematurely extracted/missing teeth are listed below:

  • Arch length may shorten.
  • In the case of primary tooth loss, permanent teeth may lack sufficient space to emerge.
  • Opposing teeth may grow in a protruding or undesirable way.
  • Premolars may become painfully impacted.
  • Remaining teeth may “move” to fill the gap.
  • The tongue may posture abnormally.

How is pulp therapy performed?

Initially, the pediatric dentist will perform visual examinations and evaluate X-rays of the affected areas.  The amount and location of pulp damage dictates the nature of the treatment.  Although there are several other treatments available, the pediatric pulpotomy and pulpectomy procedures are among the most common performed.

Pulpotomy - If the pulp root remains unaffected by injury or decay, meaning that the problem is isolated in the pulp tip, the pediatric dentist may leave the healthy part alone and only remove the affected pulp and surrounding tooth decay.  The resulting gap is then filled with a biocompatible, therapeutic material, which prevents infection and soothes the pulp root. Most commonly, a crown is placed on the tooth after treatment.  The crown strengthens the tooth structure, minimizing the risk of future fractures.

Pulpotomy treatment is extremely versatile.  It can be performed as a standalone treatment on baby teeth and growing permanent teeth, or as the initial step in a full root canal treatment.

Pulpectomy - In the case of severe tooth decay or trauma, the entire tooth pulp (including the root canals) may be affected.  In these circumstances, the pediatric dentist must remove the pulp, cleanse the root canals, and then pack the area with biocompatible material.  This usually takes several office visits.

In general, reabsorbable material is used to fill primary teeth, and non-reabsorbable material is used to fill permanent teeth.  Either way, the final treatment step is to place a crown on the tooth to add strength and provide structural support.  The crown can be disguised with a natural-colored covering, if the child prefers.

If you have questions or concerns about the pediatric pulp therapy procedure, please contact your pediatric dentist.

Testimonials.

Read what people are saying about us.

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Testimonials

If you want to know what I think of Dr. Afzali and her staff all you really need to know is that I live in Portland and I fly to San Diego to see Dr. Afzali for all my dental work. That might seem a bit extreme, and perhaps it is, but hear me out before you decide. A couple of years ago when I was living in the Bay Area I had to have one of my front teeth removed and dental implant inserted in its place by a dentist in the Bay Area. The implant looked a little shorter and darker than my other teeth, and even made my gum above it look a bit darker than the adjacent gum. In short, it didn't look natural. So I wasn't completely satisfied with how my smile looked, but I thought that was the best that could be done. It wasn't.

Last summer while I was in San Diego visiting my parents I went to Dr. Afzali for a routine cleaning. She examined my mouth and immediately asked me whether I was happy with the way my implant looked. When I said I wasn't, she explained that she could make it look better and possibly even indistinguishable from my other teeth. She was right. My implant looks just like my other teeth, and my gum is pink again. In fact, my new implant looks so natural that I sometimes forget it's an implant. I couldn't be happier. One final point. Dr. Afazli's entire staff is great. When I walk in they all make me feel like I'm the most important patient they have. And Julie is particularly great. Because I live in Portland my visits to Dr. Afzali's office had to me perfectly timed with receipt of the various parts necessary for my procedures. Julie made sure that everything arrived when necessary, without fail, so that no flights or appointments had to be rescheduled.

Riley P.

Recently, while on a trip from Canada to visit friends in San Diego, I broke a tooth. I phoned RB Dentistry and was given an appointment without delay. Dr. Mary Afzali was reassuring and professional and did an excellent job fixing the broken tooth. Her dental assistant, Marinette, was kind and gentle and made me feel comfortable throughout the procedure. Julie at Reception was welcoming, warm and made me laugh with her wonderful sense of humour and handled the insurance processing with no complications. Thank you so much Dr. Afzali, Mari and Julie for one of the most pleasant dental appointments I've had in a long time! Hope to see you in Vancouver, B.C. sometime!

Pam C.

I know I am in good hands with Dr. Afzali at RB Family Dentistry. The cavity fillings and tooth root fillings I got there were done so well that when I went to the Southwest College Dental Hygenist school to help out a friend, they could barely even detect the fillings! The teachers there were very impressed. At RB Family Dentistry, the staff and hygenists are friendly, organized and very knowledgable, and the Dr. always gives me as much time as I need and answers all of my questions. The office is beautiful and state-of-the-art. They never try to sell me on additional products or services that I don't need.

Scripps Ranch M

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16776 Bernardo Center Dr. #105 San Diego, CA 92128
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