The “pulp” in the teeth, invisible to the naked eye, is located at the center of the tooth and is composed of blood vessels, nerves and tissues. The purpose of the pulp is to channel nutrients and oxygen to the teeth. It’s easy for the pulp to be damaged by tooth decay or injury, which can lead to exposure of the pulp.
When tooth pulp becomes damaged, restoration is needed to save the tooth. Because baby teeth are needed for proper chewing, speech development and to guide incoming adult teeth, pulp therapy is often performed on baby teeth as well as permanent teeth.
Pulp therapy is known by other names, such as pulpectomy, nerve treatment, pulpotomy and root canal.
Often the first sign of injured pulp is pain, especially at night. Sensitivity to hot or cold food or beverages, redness around the tooth and/or looseness of the affected tooth is also a symptom. If your child experiences sudden dental pain, please call our Tribeca pediatric dentist to schedule an appointment as soon as possible.
While extraction of the tooth is an option, Dr. Dikansky will always strive to save your child’s tooth. Prematurely extracted/missing teeth can cause poor tooth alignment, impaction of surrounding teeth, and abnormal tongue positioning.
After x-rays and visual examination are complete, Dr. Dikansky will decide whether the tooth needs a pulpotomy or pulpectomy. The decision is based on the condition of the pulp root. In a pulpotomy, the root is salvageable so only the tip of the root is removed. Once removal has taken place, the gap is filled with biocompatible material to prevent infection. It’s most common that a crown is placed on the tooth after treatment to strengthen the tooth structure and minimize the risk of future pulp damage.
In cases of severe trauma or tooth decay, the entire pulp is removed, usually in several steps. The root canals are then cleaned and the dental area is packed with biocompatible material. In the final step, a crown is placed to add strength.
If your child loses a baby tooth earlier than normal either due to trauma or decay, or has had a baby tooth extracted, Dr. Dikansky may insert a space maintainer.
A space maintainer is a custom-made acrylic plastic or metal appliance that is either cemented in place or able to be removed as needed for dental hygiene. The purpose of a space maintainer is to keep the area open between one or more teeth so that a permanent tooth can erupt into its proper place. It’s often used when a baby tooth has been lost prematurely, such as baby teeth that are removed due to decay, or are lost due to trauma. Sometimes an artificial tooth is also inserted in the space maintainer to keep the area open for the unerupted tooth.
Your while will need a few days to get used to the space maintainer, whether it’s removable or cemented into place. Dr. Dikansky, the pediatric dentist, will show you and your child how to clean and care for the space maintainer.
It will be important that your child avoid eating foods that can loosen, get caught in or break the space maintainer, such as chewing gum, popcorn, toffee and similar foods. Dr. Dikansky will give you a list of foods to avoid. Also, please be sure your child understands that he or she should not “play” with the maintainer with his or her tongue, as this can loosen or bend the appliance.
Dr. Dikansky will schedule regular follow-up visits with your child while he or she has a space maintainer to be certain it still fits properly.
If your child needs the services of a downtown NYC pediatric dentist for routine care, trauma or tooth extraction, please call us at 212-267-0029 to schedule your child’s appointment.