Tag Archives: pulpotomy

Pediatric Dentist

Why Fill a Baby Tooth?

Can you tell me why my dentist wants to fill a baby tooth? My son has a cavity on one of his back teeth, but this isn’t his adult tooth. As it is just going to fall out anyway, why should I spend this money and put him through the procedure?

Callie

Dear Callie,

boy smiling with a toothbrush

Nobody wants unnecessary medical or dental procedures so I completely understand your question. While some baby teeth will start to fall out soon, his back molars need to stay in until he is around 12 years of age. You don’t want this cavity to turn into a dental infection. A simple cavity is easy to treat, with little trauma. If the tooth gets infected, you will need a child’s version of a root canal treatment, called a pulpotomy.

In most cases, you will want to prepare ahead of time and possibly even arrange to have oral conscious sedation used during this procedure, so he is as comfortable as possible. If you let the tooth go, it could go downhill fast, which will mean a dental emergency. In that case, oral conscious sedation may not be an option for him which would make the appointment more traumatic for him.

What If He Loses This Tooth?

Another problem with letting the decay continue is that the tooth may become unsaveable. If that happens and it has to be extracted, you will need your pediatric dentist to place a space maintainer in that spot. This will prevent the other teeth from shifting and tipping into that spot.

Without that, the other teeth will drift. This will mean there is not correct placement left for his twelve-year-old molars and will lead to crowding. Crowding means crooked teeth and expensive orthodontics.

A little prevention now by getting this tooth filled can save you and your son a lot of expense and hassle.

This blog is brought to you by Lafayette, LA Dentist Drs. Foreman and Thimmesch.

Pediatric Dentist

Did Our Pediatric Dentist Do Unnecessary Work?

I need some advice about a pediatric dental appointment we recently had. Previous to this, our son has been seeing our dentist but it wasn’t going well. He always had trouble sitting still and my dentist doesn’t really see children. It was just a temporary arrangement. We tried this pediatric dentist who said that there were a few cavities. We scheduled an appointment to take care of them using dental sedation, which went really well for our son. He doesn’t even remember the appointment. However, once it was over the assistant came out and told me that one of the cavities was so far along that they had to do a pulpotomy and place a dental crown. Was this really necessary? I feel like they did it without asking because it was not and they didn’t want me question them. How do I know whether it was necessary?

Claire

Dear Claire,

boy smiling with a toothbrush

Given the situation and your son’s wiggles (which are perfectly normal), I am guessing that the cavities were there and it is very likely that one of them had been there a while and spread to a dental infection. If that were the case, depending on which tooth it was, the pulpotomy and dental crown were necessary.

While most baby teeth can come out without a problem, back molars need to remain in place until your son is about twelve years old. If that tooth was infected then the dentist would need to deal with the infection using a pulpotomy if at all possible because he would want to save the tooth. If it wasn’t a back tooth, just extracting the tooth would be all that was necessary.

That being said, they should have spoken to you first. This is the one area where they can get in trouble for what they did. It is improper for them to do any work on your son without running it by you first. I would try having a conversation about that and let them know it is an expectation in the future. If they can’t do that, then you will need to find a different pediatric dentist.

This blog is brought to you by Lafayette, LA Dentist Drs. Foreman and Thimmesch.

Pediatric Dentist

Can tooth decay Affect the Salivary Gland?

I am trying to find a solution for my daughter. She’s had two salivary gland infections and the doctor can’t figure out why. I know the molar above the salivary gland has decay. It is a baby tooth, though, so I haven’t messed with it. It’s going to fall out anyway. Now, I am wondering if maybe that decay is causing her salivary gland problems.

Andrea

Dear Andrea,

Some baby teeth have to stay for many years.

There are a couple of separate issues here. First, let’s talk about that molar with decay. While baby teeth do fall out, your daughter’s molars need to stay until she is around twelve years old. That is when her adult molars will come in. If the molars fall out pre-maturely, then the adjacent teeth will shift or tip into the open space. This will lead to crowding and expensive orthodontics later in life.

You’ll want to preserve that back molar. I would start by getting that decay looked at and filled as quickly as possible. It’s possible at this point that the molar has become infected. If that is the case, then she will need a pulpotomy to keep the tooth viable until it is safe to come out. A pulpotomy is simply a child’s version of a root canal treatment.

I’m concerned your pediatric dentist hasn’t addressed this. Additionally, she should have had her molars sealed to prevent decay to begin with.

Now, regarding her salivary gland. Tooth infections do spread to other parts of the body, which is why they are considered dental emergencies. Because of that, if her tooth is infected, it is possible that it has spread to her salivary gland. Some dental x-rays can let you know either way. You don’t want to leave this any longer because it can also spread to her heart, lungs, or brain. All of those are close to her jaw.

This blog is brought to you Lafayette, LA Dentists Drs. Foreman and Thimmesch.

Uncategorized

Pulpotomies

My child has some decay. On one of the teeth, the dentist said, not to worry about it because it is a baby tooth, yet on another baby tooth he thinks she needs a pulpotomy. Why the different treatments? When I asked my daughter’s dentist he looked at me like I was an idiot.

Patty

Dear Patty,

I am glad you wrote. Before I answer your question, I want you to know it was completely unfair of your daughter’s dentist to respond to you that way. It is the job of a pediatric dentist to not only care for your child’s teeth, but to also answer your questions and make sure you understand why he recommends a certain treatment as well as all the options available. If he or she is not willing to do that, then it is time to get a new dentist for your child.

I haven’t seen your daughter’s x-rays, but I can take an educated guess as to the difference in treatments. With some baby teeth. it doesn’t matter if they come out early, because there won’t be too much time between the time the tooth is lost and when the adult tooth comes in.

The exception to that is with back molars. Your daughter’s adult molars will not come in until she is around twelve years old. When a space is left open that long, the adjacent teeth begin to shift into the empty space. The problem with that occurs when her twelve-year-old molars start to come in. Now that space isn’t open any longer. leading to overcrowding. Then you’ll be faced with orthodontics in her near future. Let’s avoid that if at all possible

How a Pulpotomy Helps

A pulpotomy is essentially the child’s version of a root canal treatment. By doing a pulpotomy, it protects and saves the tooth so it can stay in place until it is time for her adult molar.

If decay is left too long, it will be too late to save the tooth. When that happens, the space still needs to be reserved. In that case. your dentist will extract the tooth, but place a space maintainer there in order to keep the spot open.

This blog is brought to you by the Lafayette, LA Dentists Drs. Foreman and Thimmesch.