Pulpectomy is the minor surgical procedure performed on the primary tooth. It attempts to save the tooth and avoid extraction.

The infectious or damaged pulp is the painful condition which requires immediate attention. Pulpectomy acts as a savior in such a situation.

Pulp issues mainly arise due to extensive dental caries, tooth trauma, abscess, etc. We can not save the damaged pulp, but we can save the tooth by eliminating the diseased pulp.

Pedodontist first comfort the child undergoing the procedure, then carry forward the process and removes the infectious pulp from the pulp canal.

In the uncooperative kids, a dentist can perform extraction, but the saving of tooth is best for the kid as it helps him to eat, chew and to preserve space for the permanent teeth.

Even though the pulpectomy focuses on removal of infection and to get you relief from pain (1), the complication may arise in pulpectomy such as pain, facial swelling, excessive bleeding, etc.

But these complications are best prevented with proper care and managed by postoperative home care such as applying ice packs, having soft foods and prescribed medication, etc.

Let us go through this article to know about Pulpectomy procedure in details.

What is pulpectomy?

Pulpectomy is the pulp therapy performed on the primary teeth. The vitality of the tooth is due to the presence of pulp inside it.

The pulp is covered by the outer thick tooth coating such as dentine and enamel and transmits the pain sensation of a tooth to the brain.

When the external hard tooth coatings of the tooth get damage due to crack or decay, dental pulp gets exposed and transmits the pain.

To restore tooth in such situation dentist undergo pulpectomy which is surgical removal of infected or necrosed pulp (2). Once the diseased pulp removed from the canal, pain automatically goes away.

Pulpectomy preserves the functionality of the tooth on the cost of its vitality. Saving the primary tooth is essential as it helps the kid in chewing, eating, speaking and also preserves the space for permanent teeth.

Early removal of the primary teeth leads to the development of crowding in the permanent dentition. Hence, the efforts are made to save the primary teeth.

How is pulpectomy performed?

Most of the times, kids are uncooperative for the treatment. Hence, it is of prime concern for the pedodontist to gain the trust of the child and make the child relax before starting the procedure.

The procedure for pulpectomy carried in following steps (3).

  • Pedodontist clinically assesses the tooth and then takes the x-ray of the infected tooth. X-ray of the tooth gives the complete idea about the periapical infection, an extension of cavitation, etc.
  • The dentist now makes the kid sit in relax position and administer the local anesthesia to avoid pain during the procedure. Also, the rubber dam is then placed to achieve the isolation of the tooth.
  • Later on, the hole is made in the infected tooth to reach the canal. Once the canal located, the dentist removes the diseased pulp with the help of instruments. After the pulp removal, the canal is thoroughly irrigated with the irrigants to make the canal sterile and to avoid a further chance of infection.
  • The hollow canal then filled with antibacterial premixed paste and tooth is sealed with restorative materials. In case of extensive damage of tooth structure due to cavitation crown are mandatory after the procedure.

Pulpectomy helps your kid to get an infection-free tooth.

Who should undergo pulpectomy?

Damage to the pulp is the certain situation for pulpectomy. Not every carious lesion planned for Pulpectomy, but the following are some situation in which pulpectomy is mandatory.

  • Kids who have an extensive carious lesion which reached out to pulp causing pulpitis and pain. (4)
  • Kids with pulp damage occurred due to trauma to the teeth.
  • Kids who have an abscess in primary teeth.

Choices

There is no alternative solution for pulpectomy, but tooth removal can also perform in some conditions. Uncesarrsary tooth removal is unethical and should not practice.

However, in some situation like in case of extremely uncooperative kids who cannot sit for a longer time, tooth removal is the only option.

Following preventive measures should be taken by parents to avoid the need for pulpectomy.

  • Council, your kid about the importance of good oral hygiene.
  • Make a habit of brushing and flossing to your kid.
  • Encourage your kid to have proper oral hygiene maintenance.

Complications

Pulpectomy may sometimes cause postoperative complications such as-

  • Postoperative Infection.
  • Excessive bleeding.
  • Anaesthesia complications.
  • Overfilling of the canal.
  • Facial swelling.
  • Cold or heat tooth sensitivity.

To minimize the risk of complication dentist takes the complete medical history of the kid, carry the procedure carefully and gives the postoperative instructions and medications.

What postoperative care needed?

Postoperative home care is essential for the success of the treatment. Kids gave a low tolerance for pain, and they might complain of pain even after the procedure.

To avoid such conditions post-operative care is necessary. Few necessary steps for home care are –

  • If your kid complains of pain and develops facial swelling, apply ice packs.
  • Give your kid the prescribed dose of medication on time. Immediate action helps to minimize the chances of development of infection.
  • Give your kid soft food at least for 3-4days after the procedure.
  • Keep your kid’s mouth clean. Encourage your kid for brushing, flossing and mouth rinsing.

Final words

Pulpectomy is the best treatment options in case of pulp damage. Though the alternative solution such as tooth extraction is available, the pulpectomy gives the short route to remove infection by saving the affected tooth.

If you kid has damaged or diseased pulp and has the patience to sit in a dental chair for a long time and willingness to go for a successive appointment for the procedure then consider the pulpectomy for your kid.

Protecting your kid from germ with proper cleaning aids does not arise a need for pulpectomy. Hence, make your kid learn to fight against germs.

Pulpectomy is the minor surgical procedure performed on the primary tooth to save the tooth & avoid extraction from damaged pulp