Children’s Dentistry Sunshine Coast – Pulpotomy

Deciding between a filling, an extraction or a pulpotomy and stainless steel crown.

Within baby teeth, if decay has reached close to the nerve but the tooth is still alive, a few options exist to choose from. These options include a filling, an extraction of the tooth (with or without space maintenance) or a pulpotomy (with or without a stainless steel crown).  Each option is listed below, along with their advantages and disadvantages.

Option 1 – Filling placement

With deep decay on a baby tooth, a filling has only around a 50% chance to save the tooth.  Approximately 50% of the time, the decay has progressed too deep into the tooth and the filling does not seal well enough to prevent bacteria progressing into the nerve inside the tooth.  When bacteria reach the nerve inside the tooth they will kill the nerve which sets up a painful infection in the jawbone around the roots of the tooth.  The only option at this point is to extract the tooth to remove the infection. 

A filling is the cheapest and easiest option when there is deep decay in a tooth, but there is a strong risk that the tooth will require extraction in the future.  When decay is more shallow a filling is the best and cheapest option and will last well. 

Option 2 – Extraction of the tooth

Extraction involves removing the baby tooth and then allowing the adult tooth to erupt into the space over time.  The upsides to this treatment is that after it is completed the chances of infection or problems from the problematic tooth are virtually zero, and the cost is fairly minimal.  However there are a number of disadvantages of this option.  Extraction of a baby tooth can be potentially traumatic for your child.  After the extraction the area will be painful, bruised and swollen.  If the baby tooth is lost before it is due to fall out the space may require a space maintainer (which is the most expensive of the options outlined on this page) or risk crowding and increase the need for orthodontics in the future.

Option 3 – Pulpotomy and Stainless Steel Crown.

When deep decay is present, treatment which involves a pulpotomy and a stainless steel crown may be proposed as an option. In general, this option would have around a 90% chance of saving the tooth until it exfoliates naturally.  A pulpotomy is a limited nerve treatment, designed to remove the infected part of the nerve, but leave the healthy part of the nerve behind. This procedure is followed up with a stainless steel crown – a stainless steel cap placed over the tooth.

This option is often preferred due to having a good success rate, being well tolerated by children, and being less expensive than an extraction and space maintainer placement.

What do I do now?

At Avenue Dental at each of our practices on the Sunshine Coast your dentist or oral health therapist will discuss the advantages and disadvantages of each of the options above to help you decide the best option for you.