Question:

When should a pulpotomy be performed on a young child??

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I recently took my four year old son to the dentist for his cleaning and check up. They performed X rays and told me that he had cavities in between his two upper back teeth on both sides and in the same area on his bottom teeth. The dentist said that because they were in between the teeth that he would have to perform a pulpotomy on my son. They will be putting silver caps on eight of his upper and bottom back teeth. I am very nervous about him having this procedure and I would like to know if this is truly necessary. He has not had any pain and we take a lot of time caring for his teeth. The doctor told me that his teeth looked beautiful on the outside but this was a real problem and we really need to get it taken care of right away. I am unsure as to why he would need this done when He will be losing his teeth in only a few years. Does this sound right??

Again, I personally brush my sons teeth every morning before and after breakfast and at night before bedtime. I also floss his teeth almost every day. His insurance will cover this procedure and he will be given Valium to help calm him beforehand. I really don't want to have him go through this if he doesn't have to. Help!!!!

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  1. This is a very good question and a very valid one as well.  If you are so concerned with your Dr.'s opinion I HIGHLY encourage you to seek out a second opinion.  A pulpotomy is a procedure that removes the pulp from the tooth, I've seen this done on children with severe decay, these children are usually in a lot of pain and decay is visible.  Now the reason the procedure is preformed on "baby teeth" is because your child is still growing and so is his mouth. His teeth are vital for chewing, phonetics, space maintainers for permanent teeth, proper jaw and muscle development.  Again seek out the opinion of a different dentist maybe even an endodontist (experts in their field).  Request a copy of your child's dental record and make sure you have the XRAYS.  Good Luck


  2. You don't lose your molars- you have them for life, so if theres a problem with them now they should be dealt with asap.

  3. Pulpotomies can quickly be needed in children b/c their teeth are not very big, there is less space for a cavity to travel to get into the nerve space just like with adults. This is usually a problem between the back teeth b/c they are close together and rarely flossed, but even if they are with childrens diets and the fact that these teeth are not made to last it just happens. Caps are the best for childrens teeth b/c fillings don't tend to last as long. Front teeth are not as big a deal b/c these are the first teeth children lose, but back teeth will be kept until age 10-12. If the cavities are so big that they already will require caps and possibly pulpotomies, they will likely become infected and hurt badly before he reaches this age. If you aren't sure, get a second opinion.

  4. The baby molars are lost at about 12 years old, so that is a long time yet. It is good that your son is not yet in pain.If the decay is so deep that it has reached his nerve, a pulpotomy is the right treatment.

    Sometimes, in spite of our best efforts, tooth decay can form and very quickly.How are your teeth? Sometimes, this can be a genetic factor.Ask your dentist to evaluate your son's diet as well , maybe something in his diet is contributing to his oral condition.

    You could get a second opinion, many people do this before major dental work. Good luck.

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