What is a pulpotomy

Question:

“I have a tooth where i would like to save the portion not damaged by bacteria.  i am only being presented an option of root canal. can i opt to have a pulpotomy — usually this is only for <16.
I would like to preserve my radicular pulp/ dentin. (not symptomatic)”

Answer:

Pulpotomies are usually just a temporary fix.  More often than not, once bacteria reaches the pulp tissue, there’s no sure sign of judging the extent of it’s invasion.

Pulpotomies are oftentimes performed on primary teeth, or in emergency situations on adult teeth to alleviate extreme pain.  If it is a primary tooth, then we would encourage you to pursue the pulpotomy option.  However, if this is a permanent tooth, and you elect to have the pulpotomy, there is a chance that symptoms will return later on (anywhere from 1 week later to 1 year later).

In a situation like yours, it’s best to remove the entire pulp tissue, thoroughly disinfect and sterilize the canals, and fill with a therapeutic material to ensure the bacteria will not return.  We encourage you to have a root canal, but in the end, the decision is entirely yours.  The article below will detail decay, pulptomies, pulpectomies, and full root canal treatment.  We hope this helps you in your decision.

What is Tooth Decay?

Tooth decay (also called caries or cavities), is a very common and preventable oral disease. Basically, it happens when naturally occurring bacteria in the mouth produce acids after interacting with food (especially carbohydrates) left on teeth. This eventually wears away teeth over time if not treated. The type of treatment necessary after bacteria have caused damage to teeth depends on the extent of the decay. These include:

• Dental filling (this involves removing the decay and replacing the lost tooth structure with amalgam or dental composite material).
• If the decay has been long-standing and has compromised an extensive amount of tooth structure, an extraction may be recommended. The missing tooth or teeth may be replaced by a dental implant, dental bridge or removable partial denture as necessary and recommended by a dentist.
• Tooth decay may be extensive enough to cause a dental.  A dental abscess is serious enough to warrant immediate treatment.
• If the decay has extended to the pulp, a root canal treatment may be necessary

What is Root Canal Treatment?

After a root canal therapy, a crown (also known as a cap) is usually placed over the tooth to protect it. This is necessary because the canal(s) have been cleaned and filled, and the tooth is more susceptible to fracture (it’s more brittle). The canals formerly contained the blood and nerve supply for the tooth, which nourished and maintained the tooth.

What is a Pulpotomy?

A pulpotomy is a type of root canal treatment procedure that is usually performed on primary teeth. It involves the removal of the tissue from the pulp chamber of tooth. Pulpotomies are necessary if the pulp has been violated, either by decay or a tooth fracture. Pulpotomies are different from the root canal treatment done on permanent (adult) teeth in that only a part of the pulp is removed. A pulpotomy procedure may be recommended for a few reasons, including:

• Pulpotomy in children may prevent unnecessary loss of teeth due to a possible infection (the procedure is therefore preventative).
• Pulpotomies may be recommended to save the tooth, hence the space needed for adult (permanent) teeth to erupt.
• A pulpotomy procedure may give a developing permanent tooth a chance to fully develop, after which a conventional root canal therapy is done. This is called apexogenesis.

The success of the procedure depends on the extent of the decay and the patient’s own immune system.

What is a Pulpectomy?

More often than not, if the aim is to prevent the early loss of baby teeth, all of the pulp may be removed from the tooth. This procedure is called a pulpectomy. A pulpectomy procedure may be recommended in the following instances:

• When a tooth has a deep decay.
• When a tooth is fractured, causing exposure of or damage to the pulp.
• Where there is large dental filling.

Whether or not the tooth is symptomatic is a part of assessment that a dentist uses to diagnose the tooth’s condition. If the tooth is asymptomatic with a large decay extending into the pulp, this may be a necrotic pulp (meaning the pulp tissue is dead). Pulp necrosis is one sign that a tooth will need a root canal treatment.

We hope that this was helpful!

Pulpitis: Reversible pulpitis vs Irreversible pulpitis

Question:

“What procedure is done to fix reversible pulpitis”

Answer:

Causes of Tooth Pain

Whether it’s on and off, lingering or thumping, tooth pain is really uncomfortable and sometimes makes it hard to do anything else while the pain persists. Tooth pain causes are outlined in the article. Brushing at least twice a day and flossing daily, along with regular dental visits, are sure ways to prevent tooth decay (cavities). The modified bass technique is an effective brushing technique.

What is Pulpitis?

Pulpitis is an inflammation of the dental pulp. It’s primarily caused by bacteria that enter the pulp. The bacterial infection itself begins with tooth decay. Pulpitis may also be caused by any other type of injury to the pulp. Symptoms of pulpitis range from very mild to very severe. There are two types, and the pulpal diagnosis of each differs based of factors explained below.

What is Reversible Pulpitis?

This means that the tooth inflammation can be reversed, and the tooth symptoms relieved. The tooth therefore has a chance to heal and recover. The inflammation is usually secondary to decay, but may also be due to pulpal injury. Reversible pulpitis symptoms include:

• Tooth discomfort from contact with anything cold or another stimulus.
• Tooth symptoms that are relieved when cold or other stimulus is removed.
• Symptoms that gradually get better.
• Usually the discomfort experienced can be relieved by over the counter pain medications.

Treatment for Reversible Pulpitis

If a tooth has caries (tooth decay) and symptoms of reversible pulpitis, a dentist will remove the decay and replace the lost tooth structure with a dental filling. This reversible pulpitis treatment is usually sufficient to reverse the process. The symptoms normally improve over time, gradually disappearing.

What is Irreversible Pulpitis?

When the pulp tissue (nerve of the tooth) is damaged beyond recovery, this is known as irreversible pulpitis. The pulp will eventually die, and if the tooth isn’t treated soon enough, a tooth abscess (tooth infection) may occur.

A tooth vitality test is often done to confirm a diagnosis of irreversible pulpitis. The usual treatment of irreversible pulpitis is a root canal therapy. This is necessary in order to save the tooth. Irreversible pulpitis symptoms include:

• Spontaneous pain (pain that arises without any provocation). Tooth pain that wakes you up in the middle of the night is usually a sure sign of irreversible pulpitis.
• If the pain is brought on by a stimulus, it usually lingers even after the stimulus is removed.
• The symptoms generally get worse.
• Root canal treatment is usually necessary to treat the problem.

We hope that you found this information helpful!

I take care of my teeth. Why do I still get cavities?

Question:

I brush regularly and floss when I can.  Overall, I take very good care of my teeth.  But why do I still get cavities?

Answer:

A number of factors come into play when it comes to keeping your teeth clean.

Are You Brushing Correctly?

First off, though you brush your teeth often, are you brushing them correctly?  Make sure the bristles of your toothbrush reach every area on the tooth, including the back surface and especially the surface closest to the gumline, these are areas where bacteria usually build up.

Are You Flossing Correctly?

When you floss, do you guide the floss down below the gumline, following the curvature of the tooth?  Flossing takes more than just moving the strand between the teeth, be sure to see our article on flossing for more details.

Number of Cavities Can Be Hereditary!

And sadly, research has shown that an individual’s ability to get cavities is hereditary…that’s right, HEREDITARY!!!  So if your mother or father had a high number of cavities, than your risk of getting cavities is greatly increased.  It’s not inevitable, it just means that your mouth’s pH is more favorable to bacterial growth and development.  This means that you must take extra caution in your daily oral hygiene habits and the types of food that you consume.

Are You Eating the Right Foods?

Yet another factor that plays a large role in the development of cavities is diet.  Of course, if you have a diet that’s high in carbohydrates and sugars, you can expect more cavities.  So try to stay away from soda, candy, and a lot of bread on a regular basis.

Hope this helps and good luck!

Flossing Basics

Oh the dreaded floss.  We all know that we need to do it…everyday that is.  So why don’t most people floss?  It is a time-consuming task; however the benefits of flossing are MORE than worth the additional five minutes it takes to complete the tedious task.

So why floss your teeth?

• Mouthwash and a toothbrush can’t reach every surface of your teeth! Flossing removes the food buildup and bacteria that is located between your teeth.
• Most cavities arise from bacteria located between the teeth – This area is often overlooked. Many feel that if they can’t see it, then it isn’t a problem. However, if given the chance, microscopic bacteria can and will accumulate and begin the demineralization process of enamel slowly leading to cavities, pain, and bacterial invasion.
• You don’t want bleeding gums do you? – Bleeding gums is a sign of inflammation! If you don’t floss regularly, you can expect some minor bleeding when you start out. But don’t quit. Bleeding gums indicates gingivitis, and even worse periodontitis. If severe enough, this will lead to recession of the gums and loose teeth. Flossing removes irritating bacteria from being allowed to infiltrate your gums and cause infection.

Proper steps to flossing

• Start off with a long strand of floss (around 15 inches or so) and wrap it around each middle finger
• Use your index finger to guide the floss between your teeth
• Once the strand of floss is between your teeth, follow the curvature of each tooth in an up and down motion about 2-3 times. Don’t be afraid to push the floss under the gums, this is a critical area that needs to be cleaned.
• Remove floss and repeat with each tooth, making sure to use a clean section of the floss each time.

How often should I floss?

It’s best to floss a minimum of once a day

I tried to floss and my gums started bleeding, should I stop?  Is something wrong?

Do not stop.  This is a sign of inflammation and indicates that you haven’t flossed in awhile.  Continue to floss everyday and the bleeding will stop.

Have more questions?  Feel free to leave a commit or submit a question to be included in our FAQ’s.

Happy Flossing!