When it comes to dental treatment, especially in children, two terms that often come up are pulpotomy and pulpectomy. Although they may sound similar and both are related to the treatment of problems in the dental pulp, there are key differences between them. In this article, MEDIDENT will tell you in detail what pulpotomies and pulpectomies are, how they are performed, and how they differ.

What is pulpotomy?

First of all, we need to know what the dental pulp is. It is a soft tissue found inside the teeth. This part contains the nerves, blood vessels and connective tissue that nourish and maintain the vitality of the tooth. The pulp extends from the crown of the tooth, the part visible in the mouth, to the tip of the roots, where it connects to the tissues of the jawbone.

When we talk about treatments such as pulpotomy and pulpectomy, we are referring to procedures that are performed to treat problems in the dental pulp.

Pulpotomy is a dental treatment commonly used in paediatric dentistry. This procedure focuses on the upper part of the dental pulp, usually in primary teeth, to treat or prevent infection and maintain the vitality of the tooth. It is a crucial therapeutic option when the pulp is affected but still viable.

Pulpotomy procedure

The pulpotomy procedure involves several steps. First, a local anaesthetic is administered to ensure the patient’s comfort. Next, the affected portion of the dental pulp is removed and a therapeutic agent is applied to protect the remaining pulp and promote healing. Finally, the tooth is sealed with a suitable restorative material.

Advantages of pulpotomy

The advantages of pulpotomy include:

• Preservation of tooth vitality.
• Prevention of tooth extraction.
• Relief of pain and inflammation.
• Relatively simple and quick procedure.

Disadvantages of pulpotomy

Despite its benefits, pulpotomy also has some disadvantages:

• Not suitable for teeth with completely necrotic pulp.
• Risk of failure if infection is severe.
• Possibility of needing additional treatments in the future.

What is the pulpotomy recovery process like?

The recovery process after pulpotomy is usually quick and with minimal discomfort. Patients may experience temporary sensitivity in the treated tooth. It is recommended to avoid very hard or sticky foods and to maintain good oral hygiene to facilitate healing.

What is pulpectomy?

Pulpectomy is a more extensive dental procedure than pulpotomy, mainly used when infection or damage to the dental pulp is more severe. It is often performed on permanent teeth, although it can also be performed on deciduous teeth in certain cases. This treatment involves the complete removal of the dental pulp to save the affected tooth.

Pulpectomy procedure

The pulpectomy procedure begins with local anaesthesia. The dental pulp is then accessed through an opening in the crown of the tooth. All of the pulp is removed, including the pulp at the roots of the tooth. After cleaning and disinfecting these canals, they are filled with a special material to maintain the structure of the tooth. Finally, the tooth is sealed, often with a crown to provide added protection and stability.

Advantages of pulpectomy

The advantages of pulpectomy include:

• Effective elimination of infection and pain.
• Preservation of the tooth, avoiding extraction.
• Restoration of tooth function and aesthetics.
• Prevention of more serious dental problems.

Disadvantages of pulpectomy

However, pulpectomy also has some disadvantages:

• More complex and time-consuming procedure than pulpotomy.
• It requires post-treatment care and possibly additional restorations.
• There may be a risk of tooth fracture if the tooth is not adequately protected.

What is the pulpectomy recovery process like?

The recovery process after a dental pulpectomy can vary from case to case. Generally, it is recommended to avoid chewing on the treated tooth until a final restoration is placed. There may be some sensitivity or discomfort, which is managed with medication recommended by the dentist. As with any dental procedure, good oral hygiene and follow-up appointments are essential to ensure a good recovery.

What is the most appropriate treatment?

Determining the most appropriate pulp treatments and choosing between pulpotomy and pulpectomy depends on several factors, including the age of the patient, the type of tooth affected (temporary or permanent) and the extent of damage or infection in the dental pulp.

• For primary (baby) teeth: Dental pulpotomy is usually the preferred treatment if the infection or damage is limited to the upper part of the dental pulp. This procedure is less invasive and preserves more tooth tissue, which is important to maintain space and guide the development of permanent teeth. We could say that pulpotomy on primary teeth is more common.
• For permanent teeth: Pulpectomy is often necessary when infection or damage has spread throughout the entire dental pulp, including the roots. This treatment is more thorough and removes all pulp tissue to prevent the spread of infection and save the tooth.

In both cases, the choice of treatment will depend on the diagnosis and recommendation of the dentist or endodontist, based on a detailed evaluation that may include x-rays and tooth sensitivity tests. The decision is always made for the best outcome for the patient’s dental and general health, considering the preservation of the tooth and the prevention of future dental problems.

When to go to the dentist: The importance of getting professional help

We always stress the importance of recognising when it is the right time to see a dentist, because early intervention by a professional can make all the difference to the prognosis and treatment of dental conditions.

• Persistent or sharp pain: If a child experiences constant or severe pain in a tooth, it is a sign that something is wrong. The pain may indicate an infection or inflammation in the dental pulp that needs immediate attention.
• Sensitivity to extreme temperatures: Sensitivity to cold or heat, especially if it persists after the temperature source has been removed, may be an indication of pulp problems.
• Dental trauma: Any blow or injury to the teeth, especially in children, should be evaluated by a dentist, even if initially there appears to be no visible damage.
• Deep or visible decay: Untreated decay can deepen into the pulp, causing infection and requiring more complex treatments such as pulpotomy or pulpectomy.
• Changes in tooth discolouration: A tooth that changes colour, becoming darker, may be a sign of pulp damage.
• Swollen or abscessed gums: Any swelling or pocket of pus around a tooth is a warning sign that requires immediate dental attention.

Early visits to the dentist allow for accurate diagnosis and timely treatment, which is essential to preserve dental health and avoid complications. Dentists and endodontists are trained to assess and treat these problems properly, ensuring the best care for oral health.

Conclusions

At Medident Clinic we are dedicated to offering personalised solutions for the dental health of the whole family. Our team of specialists is equipped with the necessary experience and tools to offer you all the dental care with the maximum guarantee of success. In our clinic, each patient receives detailed attention adapted to their specific needs. If you have any questions about this or other dental health issues or would like to request a diagnostic appointment, please contact us, we will be happy to help you!