Nerve Treatment (Pulpectomy) - A Remedy to Preserve Baby Teeth

Why Do Children Need Pulpectomy?

The child may need nerve treatment (pulpectomy) because of the following reasons:-

• If they experience toothache and pain besides tooth sensitivity to hot and cold temperatures.
• If they have an untreated cavity which is neglected for too long, allowing the dental pulp/nerve within the tooth to become infected.
• Tooth decay also develops under dental fillings to eventually involve the dental pulp.
• If the child has undergone any type of dental trauma or injury that has caused a tooth to crack or break to a point that pulp has been exposed.

Why Can’t We Have a Normal Filling Instead of a Pulpectomy?

Fillings are placed when the decay is only affecting the first two layers of the tooth – the enamel and the dentine. But when the infection reaches within the nerve of the tooth, it needs special treatment. If not treated timely, the nerve will eventually die and an abscess can occur when the infection spreads outside the tooth. The permanent tooth buds develop in proximity to the roots of baby teeth, so untreated infection can spread there and affect the normal development of the permanent teeth. In addition to severe pain, the infection or abscesses can cause fever and other health problems.

How is a Pulpectomy Treatment Done?

• It typically begins with the application of local anaesthetic agent to numb the affected tooth and the surrounding tissue.
• An opening is made through the top of the tooth. The decay and infected nerve are removed, and the canals are cleaned and shaped using instruments like small files, then washed with an antiseptic and dried.
• The empty root canal spaces are then filled with a bio-compatible paste which resorbs as the tooth root starts shedding.
• A filling is then placed in the top part of the tooth. An x-ray will be taken to check the root filling.
• Most teeth with pulpectomies will require a crown (cap). As when the nerve is removed, the tooth becomes more brittle and prone to fracture.

What are the Precautions to be Taken After Pulpectomy?

• Avoid eating and drinking for at least 20 minutes after the procedure.
• If the child is under local anaesthesia, they should be extra careful not to bite their lip or tongue until the effect of numbness has worn off, and avoid hot food and drinks.
• They may experience mild pain or discomfort as the tooth settles down. To relieve the pain, painkillers like Paracetomol (Calpol or Crocin) can be prescribed.
• Avoid biting heavily on the tooth until a cap has been fixed on the tooth, as the tooth may be brittle and prone to fracture.
• The teeth should be brushed normally.