Pulpotomy and Pulpectomy in Primary Teeth
Pulp treatment in primary teeth: how to preserve the tooth and protect your child's dentition
Pulpotomy and pulpectomy are pulp treatments for primary teeth that allow the tooth to be preserved when decay reaches the inner tissue or when infection is present.
The aim is to eliminate pain, control infection, and keep the primary tooth in the dental arch until the time of its natural shedding.
At Clínica Dr. Paulo Cardozo, in Benavente, pulp treatment in primary teeth is carried out using child-appropriate techniques and biocompatible materials, in accordance with the guidelines of the AAPD (American Academy of Pediatric Dentistry).
Clinical and radiographic assessment determines whether a pulpotomy or pulpectomy is the most appropriate treatment for each case.
If your child has pain in a primary tooth, persistent sensitivity, or signs of infection, book an assessment appointment.
Technology Supporting Pulp Treatment
At Clínica Dr. Paulo Cardozo, the diagnosis and planning of pulp treatment in primary teeth are supported by digital imaging examinations that allow assessment of the pulp condition, the extent of the lesion, and the integrity of the root.
Diagnosis with Periapical Radiograph
The digital periapical radiograph is the reference examination for assessing the condition of the pulp and root of a primary tooth. It allows identification of periapical infection, assessment of the degree of root resorption, and verification of how close the permanent tooth germ is — all essential information for deciding between a pulpotomy and a pulpectomy.
Panoramic Assessment with Orthopantomogram
The digital panoramic X-ray provides an overall view of the child's entire dental arch and allows assessment of the degree of development of the permanent teeth, the position of the tooth germs, and the general state of the dentition. This examination is an important complement in the assessment of cases involving multiple affected teeth.
Caries Detection with Bitewing Radiographs
Bitewing radiographs allow detection of deep caries between primary teeth that may be progressing towards the dental pulp. Early detection of these lesions means pulp treatment can be carried out before infection takes hold.
“Preserving a primary tooth means preserving the space and function within the child's dental arch. With appropriate pulp treatment, we can keep the tooth until the right time for natural shedding and avoid complications in the development of the permanent dentition.”
What are pulpotomy and pulpectomy in primary teeth?
The dental pulp is the soft tissue inside the tooth that contains nerves and blood vessels. When decay progresses and reaches the pulp, or when trauma exposes this tissue, intervention is necessary to eliminate pain and control infection.
A pulpotomy involves the removal of the portion of the pulp located in the pulp chamber (the coronal part) whilst preserving the pulp in the roots.
This treatment is indicated when the radicular pulp remains vital and shows no signs of infection. After the affected tissue is removed, a biocompatible material is placed and the tooth is restored with a paediatric crown for full protection.
A pulpectomy is indicated when the infection has also reached the radicular pulp or when pulp necrosis is present.
In this procedure, the pulp is removed in its entirety, the root canals are cleaned and filled with a resorbable material that allows the natural shedding of the primary tooth and healthy eruption of the permanent tooth.
The AAPD recommends that, following pulp treatment, the primary tooth be restored with a crown that ensures a complete seal against bacterial infiltration.
At Clínica Dr. Paulo Cardozo, each case is assessed individually and the type of pulp treatment is selected based on clinical and radiographic evaluation.
What our patients say
My son's primary tooth had a very deep cavity and the dentist managed to save it with a pulpotomy. He felt no pain and the tooth was protected with a crown.
Sofia Ribeiro
My daughter was in severe pain with a primary molar. They performed a pulpectomy and the pain subsided immediately. We were relieved to know that the tooth will remain in place until it falls out naturally.
Carlos Martins
I was apprehensive about the treatment, but the team explained everything calmly. The pulpotomy was quick and my daughter left the appointment relaxed.
Teresa Vara
4 Steps to Your Child's Primary Tooth Pulp Treatment
Pulp treatment in primary teeth at Clínica Dr. Paulo Cardozo follows a structured protocol, from diagnosis through to follow-up, to preserve the tooth and protect the development of your child's dentition.
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Clinical and radiographic diagnosis
The dentist carries out a clinical examination to assess the child's symptoms and requests a periapical X-ray to determine the condition of the pulp and root of the primary tooth. Based on this assessment, it is determined whether the indicated treatment is a pulpotomy or a pulpectomy.
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Anaesthesia and pulp access
Local anaesthesia is administered so that the procedure is painless. The dentist removes the decay and accesses the pulp chamber of the tooth. At this point, the condition of the root pulp is assessed to confirm the clinical decision regarding the type of treatment.
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Pulp Treatment
In a pulpotomy, the coronal pulp is removed and the radicular pulp is treated with a biocompatible material. In a pulpectomy, the entire pulp is removed, the root canals are cleaned and filled with a resorbable material. In both cases, the aim is to eliminate the infection and preserve the tooth in the arch.
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Restoration and follow-up
The treated tooth is restored with a paediatric crown that provides complete protection and a seal against bacterial infiltration. Clinical and radiographic follow-up is carried out at routine appointments to assess the response to treatment and the integrity of the tooth.
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Clinical and radiographic diagnosis
The dentist carries out a clinical examination to assess the child's symptoms and requests a periapical X-ray to determine the condition of the pulp and root of the primary tooth. Based on this assessment, it is determined whether the indicated treatment is a pulpotomy or a pulpectomy.
0
Anaesthesia and pulp access
Local anaesthesia is administered so that the procedure is painless. The dentist removes the decay and accesses the pulp chamber of the tooth. At this point, the condition of the root pulp is assessed to confirm the clinical decision regarding the type of treatment.
0
Pulp Treatment
In a pulpotomy, the coronal pulp is removed and the radicular pulp is treated with a biocompatible material. In a pulpectomy, the entire pulp is removed, the root canals are cleaned and filled with a resorbable material. In both cases, the aim is to eliminate the infection and preserve the tooth in the arch.
0
Restoration and follow-up
The treated tooth is restored with a paediatric crown that provides complete protection and a seal against bacterial infiltration. Clinical and radiographic follow-up is carried out at routine appointments to assess the response to treatment and the integrity of the tooth.
Everything you need to know about pulpotomy and pulpectomy in primary teeth
Primary teeth serve essential functions in chewing, speech, and maintaining space for the permanent teeth.
When decay reaches the pulp of a primary tooth, pulp treatment is the way to preserve the tooth in the arch and avoid the need for extraction.
The difference between a pulpotomy and a pulpectomy depends on the extent of the lesion:
- In a pulpotomy, only the pulp of the coronal chamber is removed, because the radicular pulp remains healthy.
- In a pulpectomy, the infection has already reached the pulp of the roots and the entire pulp tissue must be removed.
The dentist determines the appropriate procedure based on clinical examination and periapical X-ray.
After pulp treatment, restoration of the tooth with a paediatric crown is essential.
AAPD guidelines indicate that placing a crown over the treated tooth significantly improves the longevity of the treatment, as it prevents bacterial infiltration and protects the remaining tooth structure.
At Clínica Dr. Paulo Cardozo, pulp treatments are carried out using biocompatible materials and with radiographic monitoring to verify resolution of the infection and normal root resorption. If your child has pain or sensitivity in a primary tooth, book an assessment appointment.
Main problems treated with pulpotomy and pulpectomy
Pulp treatment in primary teeth is indicated when decay or trauma reaches the dental pulp and compromises the vitality of the tooth.
At Clínica Dr. Paulo Cardozo, each case is assessed individually. Find out about the most common indications.
Deep Caries with Pulp Exposure
Tooth decay, when not treated promptly, can progress until it reaches the pulp of the primary tooth.
Exposure of the pulp causes intense pain, sensitivity to cold and heat, and, if left untreated, can develop into an infection. Pulpotomy is the indicated treatment when the radicular pulp remains vital.
At Clínica Dr. Paulo Cardozo, the periapical X-ray allows the extent of the decay and the condition of the pulp to be assessed in order to define the most appropriate treatment for your child.
Pulp Necrosis and Abscess in a Primary Tooth
When pulp infection is left untreated, necrosis (death of the pulp tissue) can occur, along with the formation of a periapical abscess, causing pain, swelling, and sometimes a fistula.
Pulpectomy is the indicated treatment to remove the necrotic tissue, clean the root canals, and eliminate the source of infection.
At Clínica Dr. Paulo Cardozo, radiographic assessment is essential to confirm the diagnosis and monitor the resolution of the infection following treatment.
Dental Trauma with Pulp Exposure
Trauma to a primary tooth (a fall or impact) can result in crown fracture with exposure of the dental pulp. When the exposure is recent and the pulp remains vital, a pulpotomy allows the tooth to be preserved.
In cases of pulp necrosis following trauma, a pulpectomy may be necessary.
At Clínica Dr. Paulo Cardozo, emergency care for dental trauma includes immediate clinical and radiographic assessment to determine the best approach for each case.
Discover Clínica Médica Dentária Dr. Paulo Cardozo
At Clínica Dr. Paulo Cardozo in Benavente, pulp treatment in primary teeth is carried out using biocompatible materials, digital imaging diagnostics, and individualised monitoring to preserve your child's dentition.
Book your appointment
If your child has pain in a primary tooth, prolonged sensitivity, or signs of infection such as swelling or a sinus tract, book an appointment at Clínica Dr. Paulo Cardozo and receive an appropriate diagnosis and treatment plan.
Clínica Dr. Paulo Cardozo
R. Vasco da Gama 6,
2130-197 Benavente, Portugal
Telephone: +351 263 516 773
Mobile: +351 919 366 534
geral@clinicapaulocardozo.pt
Frequently Asked Questions
About Pulpotomy and Pulpectomy in Primary Teeth
What is a pulpotomy?
A pulpotomy is a treatment of the pulp of a primary tooth that involves removing the affected pulp in the coronal chamber whilst preserving the healthy pulp in the roots. It is indicated when decay or trauma exposes the pulp, but the radicular pulp remains vital.
What is the difference between a pulpotomy and a pulpectomy?
In a pulpotomy, only the coronal pulp is removed. In a pulpectomy, all the pulp (coronal and radicular) is removed because the infection has reached the roots or the pulp tissue is necrotic. The dentist determines the appropriate treatment based on clinical and radiographic assessment.
Is pulp treatment painful?
The procedure is carried out under local anaesthesia and is painless for the child. The team uses behavioural management techniques adapted to the child's age to ensure the experience is comfortable and safe.
Is it better to treat or extract a primary tooth?
Whenever possible, pulp treatment is preferable to extraction, as it allows the primary tooth to be preserved in the arch and maintains the space for the permanent tooth. Extraction is reserved for cases where pulp treatment is not viable.
Will the treated baby tooth fall out normally?
Yes. In pulpectomy, the canals are filled with a resorbable material that allows normal root resorption and the natural shedding of the primary tooth at the appropriate time.
What happens after pulp treatment?
The treated tooth is restored with a paediatric crown that provides complete protection. Clinical and radiographic follow-up at routine appointments allows confirmation that the treatment is progressing favourably.
Is a pulpotomy safe for children?
Yes. Pulpotomy and pulpectomy are procedures recommended by the AAPD and the EAPD as safe and effective treatments for preserving primary teeth with pulp lesions. The materials used are biocompatible.
What happens if the pulp of a primary tooth is not treated?
The infection can progress, causing severe pain, abscess, and compromising the development of the underlying permanent tooth. Timely assessment and pulp treatment are therefore essential.
Does the Dr. Paulo Cardozo Clinic carry out pulp treatments on primary teeth?
Yes. Clínica Dr. Paulo Cardozo, in Benavente, performs pulpotomies and pulpectomies on primary teeth using biocompatible materials, digital imaging diagnosis, and individualised follow-up. Book your appointment.
Clinical Rigour and International Standards
The clinical team at Clínica Dr. Paulo Cardozo guides its paediatric dentistry practice in accordance with the guidelines of the leading oral health reference bodies, including the FDI World Dental Federation, the Ordem dos Médicos Dentistas (OMD), the World Health Organization — Oral Health, the American Academy of Pediatric Dentistry (AAPD), and the European Academy of Paediatric Dentistry (EAPD).
The continuous training and professional development of the clinical staff at Clínica Médica Dentária Dr. Paulo Cardozo, together with the integration of international recommendations into their practice, ensures that every procedure is carried out with safety and medical responsibility.