When it comes to endodontic treatment, do you know the difference between a pulpotomy and a pulpectomy?

When it comes to endodontic treatments, it can be easy to get confused by the technical terminology. When it comes to your young child’s smile, one common source of confusion for many parents is understanding what the difference is between getting a pulpotomy or a pulpectomy done. While both procedures involve treating an infected or damaged tooth pulp, they are not interchangeable.

Dental Pulp

First, let’s review what dental pulp is. The pulp is the soft material comprising the inside of a tooth that holds the tooth nerves, blood vessels, and connective tissue. It’s surrounded by the harder layers of dentin and enamel, which make up the visible part of the tooth. Whenever a tooth pulp becomes infected or damaged, it most often leads to serious pain, tooth sensitivity, and potentially losing the tooth altogether if it is not treated promptly.

Pulpotomy

A pulpotomy is a dental procedure that involves taking out part of the tooth pulp, more specifically, the pulp in the crown of the tooth. This treatment is often done on baby teeth (or primary teeth) that have severe decay or dental trauma; even so, the root is still healthy. Our goal when performing a pulpotomy is to save the baby tooth until it falls out on its own. This is important for maintaining proper spacing and alignment of the adult teeth that will come in and replace them eventually.

During a pulpotomy, we first numb the area around the affected tooth and excise any decayed or damaged tissue within. Then we can remove the upper part of the pulp and place medication on it to prevent further decay from occurring. Then, we will fill the tooth with a temporary filling until it’s time for the baby tooth to finally fall out. In certain situations, a stainless steel crown may be placed onto the baby tooth to keep it safe until then.

Pulpectomy

Conversely, a pulpectomy may be needed, and this is a more extensive treatment involving excising all of the pulp material from the affected tooth (this includes the roots as well). A pulpectomy is most often done on adult teeth that have become infected or damaged so badly that a pulpotomy would not make a dent. Having a pulpectomy effectively saves the tooth from an extraction while also keeping the infection from spreading to nearby teeth or the jawbone.

During a pulpectomy, we will numb the area surrounding the affected tooth before making an opening in the top part of the tooth to get to the pulp material. Next, we can remove all of the pulp, including any infected tissue, and then clean and shape the canals located in the tooth. Once these canals are cleaned, we can then fill them with a special material followed by sealing the opening in the tooth. Most often, a crown is placed over the tooth to protect it from being damaged any further.

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As you can see, even though both pulpotomies and pulpectomies involve treating the infected or damaged tooth pulp, they are still not the same procedure at all. In summary, a pulpotomy involves taking out part of the pulp in a baby tooth to save it until it can fall out naturally, while a pulpectomy involves taking out all of the pulp in an adult tooth to save it from extraction. If you’re unsure which procedure is necessary for your child or yourself, our endodontic team can help! We welcome you to call us with your questions and concerns.