A guide to Vital pulpotomy

What is vital pulpotomy?

Vital pulpotomy removes part of a tooth’s pulp which is the centre of the tooth that houses the blood vessels and the nerves. The component that is removed is located inside the crown. This is the part of the tooth that you will see above the gum line. Vital pulpotomy removes less pulp compared to a root canal treatment. Root canal treatment will remove all of the pulp, including the parts in the roots of the tooth that are below the gum line.

Vital pulpotomy is usually done on children where decay has affected the crown part of the pulp. The nerves at the roots of the tooth are still healthy. The procedure is also done when the pulp is exposed because of some sort of injury or trauma. The affected part of the pulp could be removed and the healthy part of the root is left behind.

Successful vital pulpotomy will relieve sensitivity and pain and it will also prevent the supporting tissues around the tooth from breaking down.

What is vital pulpotomy used for?

If the crown of a tooth is injured or if it is decayed but the pulp in the root is still healthy then vital pulpotomy can save the nerve inside the root from dying. In order for your dentist to perform a vital pulpotomy, the tooth must not be loose or have any swelling or abscesses surrounding it. If there is swelling or abscesses then you may have to get another form of treatment.

Vital pulpotomies can be done on primary teeth or in young permanent teeth. For primary teeth, the procedure is done so that the primary tooth is saved from extraction. Extracting a primary tooth before it is about to fall out will alter the way permanent teeth erupt into the mouth.

If the pulp of the permanent tooth is injured or if it decayed after it erupts into the mouth then root canal treatment may be necessary. Root canal treatment should only be done when the roots have completely grown. In this case, vital pulpotomies are done instead. Root canal treatment can be done afterwards.

How do you prepare for a vital pulpotomy?

Your dentist will take x-rays of your tooth’s position and anatomy so that infections at the root can be identified. Vital pulpotomy is done on patients under local anaesthesia or sedation. Nitrous oxide or oral medicines may be used. Sedation will help calm anxious children who are unable to cope with local anaesthesia only.

How is a vital pulpotomy done?

Your dentist will use a drill and some hand instruments to remove the decayed areas from the tooth so that they can gain access to the pulp. Your dentist will remove the damaged pulp and then your dentist will place medicine over the remaining root part of the pulp. The dentist will put a temporary filling left in the tooth after the root canal can be performed.

What are the follow-up procedures after the vital pulpotomy?

The gums of your child may be sore in the operated area so allow your dentist to check on it from time to time.

What are the risks of vital pulpotomy?

The success rate of vital pulpotomy is ninety to ninety five percent. Failures and other problems can still occur. Some of the medications used in vital pulpotomy can irritate the tissues outside the pulp. This can give a burning sensation in the area of the affected tooth.

If the nerves of the tooth are infected then vital pulpotomy will fail. Your dentist will try their best to look for infections during the procedure. In the early stages of infection, sometimes the nerves still look healthy and the dentist may overlook it.

If the tooth continues to hurt after the vital pulpotomy then root canal treatment may be needed. This will remove the remaining pulp.

You can use over-the-counter painkillers to remedy the pain that occurs after a vital pulpotomy. If the pain still persists then you should contact your dentist immediately. If swelling develops then you should contact your dentist as soon as possible.

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