Tuesday, June 14, 2011

What is a Root Canal?

What is a Root Canal? Sounds bad doesn’t it? Well, where a pulpotomy is the removal of the pulp tissue in the upper chamber of the tooth, a pulpECTOMY (root canal) is the complete removal of all pulpal tissue including down to the end of the roots. Root canals are often needed if a front tooth is traumatized or even knocked out. Yes, we can often save a knocked out permanent tooth, but it may take a root canal to do it. Often severely decayed teeth simply “give up the ghost” and die. All that dead stuff in there, well, the body cannot get to it to naturally clean it up.











We dentists do root canals or pulpectomies if the tooth is dead. There is a slight difference in how we approach permanent teeth as opposed to baby teeth. With permanent teeth, pulpectomies are often used to “save” a dead or abscessed tooth. You have to get the dead tissue out. You can get it out with a pulpectomy or you can take the tooth out all together. Well, if it’s my tooth, I would rather save a needed permanent tooth if at all possible with a pulpectomy. Some permanent teeth have up to four canals; that can be very complicated and expensive. By the way, I often refer patients (usually teenagers) to the Endodontist for permanent tooth root canals. They do that kind of stuff all day long, are experts, and have all the tools right at hand. Root canals are very useful at saving permanent teeth.






Now, in baby teeth it is a little different. If a baby tooth abscesses, you usually choose to remove it rather than attempt a root canal/complete pulpectomy. Why not do a root canal to save the tooth? Well, on rare occasions we do try, but there are several reasons that we do not. First, root canals on baby teeth do not really work that well. Pulpotomies do. Full root canals are more unpredictable as far as results. Secondly, often there is not enough baby tooth root left to adequately remove and fill the canal space. You see, baby teeth roots are meant to slowly dissolve as the permanent tooth erupts. Baby teeth have anatomical differences that you don’t see as much in permanent teeth: accessory canals, unseen vascular openings, twists and turns, and great variation. Also, as far as filling up the cleaned out root canal space, well, you can’t put in the regular gutta percha material. You have to put in something that will dissolve along with the baby tooth root or at least not interfere with the normal process. Hmm, what to do? Well, 99% of the time, where we cannot do a pulpotomy (i.e. the tooth is still vital), we need to remove the abscessed baby tooth. Fortunately, removal of the tooth is 100% effective at removing the offending stuff in there. Healing will take place rapidly. Unfortunately, if you loose the baby tooth too soon you need to place a space maintainer.
Why would you even try a pulpectomy (root canal) on a baby tooth? Good question. Like I stated, most of the time if the tooth is still vital and just has lots of decay, you can do a pulpotomy. If it is abscessed, we remove the tooth. Now, there are rare times we might attempt a real baby tooth root canal. The one that comes to my mind is when you have a second baby molar (the one in the way far back) that is dead, but not to the point of bone loss and severe symptoms, and the new permanent 6year molar is just about to erupt, and there is no easy way to place a space maintainer. If there is enough root structure, and if the tooth is not mobile and causing massive infection, cleaning out the dead tissue with a root canal might just keep the tooth viable long enough for it to guide in the permanent molar. Once it is in, if the baby tooth gives trouble you can easily remove it and place a proper space maintainer, or if the new tooth is fairly close, just remove it and allow the new tooth to erupt without incident. Sometimes we will do this on front baby teeth to help save the tooth for appearances sake. Problem is, that front teeth come out earlier than the back teeth, so if the child is any older than about four and half there may be root resorption from the erupting tooth. If the child is any younger than three years old, and the issue of cooperation becomes a bigger issue.
How do you do it?
With a baby tooth pulpectomy (root canal), it get’s a little technically detailed as to what you have to do. First, you need a relatively cooperative patient. It is easier to work on a slightly wiggly child to remove a tooth than do technically more precise procedures. Second, you have to remove the bulk of the necrotic or dead tissue. That is sometimes more difficult due to the strange anatomy of baby teeth. The good news is that you usually do not need to be as precise with the cleaning and filing out process as with a permanent tooth. You try to do a thorough job, but you don’t have to spend what seems like hours filing out the root canals of the tooth. Once the tissue is removed and the canals filed out and irrigated as best you can, you place something like Zinc Oxide Eugenol paste or various other kinds of paste materials in there. It kind of sets up after a few minutes and hopefully seals it all up. Then you usually do a crown on top to seal it up and restore an obviously very decayed tooth. Then you need to observe the tooth for a few months/years, to make sure there are no further problems.

55 comments:

Jamie said...

Could you please help me sort out these two differing opinions? A year ago our family dentist saw 4 small cavities in my 8 year old son's baby teeth, (all were between the first and second pre-molars on both sides, top and bottom). He said to wait a year and watch them. After the x-rays a year later two were a little worse but two had grown enough to need fillings. Our family dentist was going to do the fillings but he doesn't work on many children and I thought a pediatric dentist would be best. When we went for an evaluation the pediatric dentist, (supposed to be the best in the area), is saying there is a 50/50 chance he will need a pulpotomy and crown on one tooth. (He also thinks all 4 cavities should be filled.) I was dismayed because our family dentist doesn't even do pulpotomies, so he obviously didn't think there would be a need for one, since he was going to do the cavities himself. Is this a reasonable difference of opinion between dentists? I don't mind filling all the cavities but I really don't want all the extra major work, (pulpotomy and crown), if it is not needed. I understand it is hard to know until you get in there, but obviously our family dentist saw the x-rays differently. Is it just a matter of one being conservative and one being more aggressive in their treatment? I don't know if I should get a third opinion and meanwhile time marches on and the cavity may be growing. Thank you for your help as I am stuck! Jamie

Dr. Dean Brandon said...

I cannot address in a few sentences all your concerns. I can say it is very common for a small cavity to become larger. If the decay is too close to the pulp of a baby tooth, a pulpotomy is the standard of care. If a pulpotomy is not done and say only a filling is done, there is the risk of a tooth ache and or abscess due to not treating the pulp. Yes sometimes you cannot tell till you get in there. The difference between "just a filling" and a pulpotomy and crown is often the distance the diameter of the period at the end of this sentence. It us not conservative vs aggressive.

There have been times where I thought a pulpotomy and crown were necessary but when I got in there I decided it was not needed. I would tend to go with a dentist who sees this kind of stuff all the time: the pediatric dentist.

Assure a Smile Miami Dentistry said...

Great diagrams and information!

Would you mind if we linked to this article from our blog? This could serve as a great reference to an upcoming blog post...

Dr. Dean Brandon said...

You may link with attribution in accordance with the creative commons copyright

Linking is fine.

Dr.geet vijay said...

Dr.Dean sir do u really think Pulpotomy really works...How can u say that infection has just affected coronal pulp and it has left radicular pulp completely free of infection and inflammation.....surely pulpotomies can be tried in immature vital permanent teeth with open root apices(apexogenesis)but that also has got limited chances of success...

Dr. Dean Brandon said...

First, pulpotomies are for baby teeth, and yes, they are very effective in non-abscessed teeth. Pulpotomies on permanent teeth in the past were not done really at all. It was pulp cap or root canal all the way. These days in non necrotic teeth things like a Sveck pulpotomy with MTA seems to work well when diagnosed correctly (usually on traumatized permanent incisors. )

Chirurgia Orale said...

Really interesting article to share! Thanks

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Anonymous said...

First up, I want to thank you for this great resource that you have maintained. My question is not related to root canal. I'm just posting it here as I could not find a relevant post on your blog. My 10 year old has not lost one of his baby teeth(bottom left lateral incisor N) even though the permanent tooth has sprung up from behind pushing this outward and sideways. The tooth never wiggled or got loose, even though we tried a lot. Is it possible that it will never fall? Do we have to use the help of a dentist to get it out. What happens if we leave it as it is?

Thanks for your time and effort!

Dr. Dean Brandon said...

Try here:

Permanent Teeth Coming in Behind Baby Teeth

dentist scarborough said...

Great Article and nice use of visuals. I'm thinking of starting a blog on my business website and provide similar information to my patients.

Jamie said...

I would like to get into a dentist like you who allows parents to come back with the child, but the next available appointment is 7 weeks away. If I give extraordinary care to my son's cavities, (brush and floss after any food/drink), will the decay process be stopped or slowed enough to wait this long? My other option is to go with a dentist who does not allow me to come back, (he will if I am adamant about it, but then I feel I have irritated the person working on my son's teeth). Thank you so much for your obvious care for others.

Dr. Dean Brandon said...

Decay does get worse with time. How fast is hard to say. You should feel comfortable with your pediatric dentist though. I'd go the where you like the most. With our patients, a few weeks usually does not make a big difference in the extent of treatment needed.

Jamie said...

Do you ever perform an indirect pulp cap on a baby tooth if the decay has not reached the pulp and all the circumstances are right?
Thank you for your helpful information...what a blessing.

Dr. Dean Brandon said...

An IPC on a baby tooth... is not usually done. If the decay is very close to the pulp and you fear it might go into the pulp if you remove it, then an IPC might be indicated in a permanent tooth. If you do that on a baby molar where you leave decay like that, the chances of it abscessing later on are fairly high. Even when all the decay is removed, but you are very very close to the pulp of a baby molar you still would usually opt for the pulpotomy. (distances in baby teeth are very much smaller than in permanent teeth as well). Again, if you don't do a pylpotomy, the chances of abscess are greater. If you do a pulpotomy on a baby tooth, the chances of a problem are very small. See my post on pulpotomy.

I never leave decay in a baby tooth. (at least not on purpose). The science is just not there to support that. Ask most pediatric dentists that see lots of cases and I suspect you will get the same answer.

Dr. Dean Brandon said...

Jamie,

Just to clarify. You asked: "if the decay does not reach the pulp". In an indirect pulp cap (IPC), you leave decay there, then come in much later on to remove it. How do you know it hasn't reached the pulp? If you remove all of it and you see it is not into the pulp, then it is not technically an indirect pulp cap.

Like I said, even if you do remove all the decay, but you are obviously close, there are actually microscopic tubules that make it very likely it has reached the pulp even though you do not see or feel it. That is why pulpotomies in baby teeth are so useful. Baby teeth are not just little permanent teeth. They are different. The anatomy is different and the way they usually respond is different.

Anonymous said...

Thank you for providing such a dynamic, informative blog. My 4 yr old had trauma to her bottom, front baby teeth. Now a few weeks later, one of them has turned a light gray color. I understand this is normal and it hopefully will turn back to white. I understand it takes 'awhile'. Awhile as in weeks or months? After what timeframe should I begin to worry about it if it doesn't turn back? Thank you for your time and expertise.

Dr. Dean Brandon said...

See here:
My child's tooth is turning dark

Teeth Whitening Reviews said...

Great post. But I would like to know more on what kind of budgets they usually adhere to before I can actually opt for one! Much thanks! :)

Doylestown Teeth Whitening said...

Your post is pretty useful for the dental community. Thanks for taking the time and effort.

Dental Clinic Melbounre said...

Great advice, and some good info on pulpotomy. There are lots of concerned parents out there, and this could be very helpful to them

Teeth Cleaning said...

Good info! Thanks for this

Anonymous said...

Dr. Dean, My 3 year old daughter had a small white mark in between her two front teeth which i noticed was starting to look a little bit brown from the back so i took her in for an xray and exam. She was very anxious and upset and they werent able get an xray or even much of an exam, but he told me he could see something and she may need "two baby root canals, and two tooth colored crowns." he said that in front baby teeth cavities get to the root very quickly because the root is so big, and the tooth so small. Is this true? or is it also common to be able to fix a small cavity in that location with just a filling? We do not have insurance so the quoted price for sedation, xray, pulp therapy, and crowns was over $1,200. I scheduled the appointment for late october (the earliest they had) But after researching anterior cavities in primary teeth on my own, and learning about caries, I feel like the work he suggested would be for much worse cavities. I have always brushed her teeth twice a day, and since discovering this mark we brush three times a day and shes never been given bottles at bedtime so I feel that her tight teeth and failed attempts at flossing regulary are to blame. I would like to get a second opinion before following through with any sedation or work, but like i said, we are without any insurance so this is all very overhwelming and expensive. Any advice or input that you have on my situation would be greatly appriciated! Thank you!

Dr. Dean Brandon said...

I cannot say specifically as each case is different, but--small cavities=small fillings, even on baby front teeth. If the cavities are deep (close to or into the pulp), than sometimes some sort of pulp therapy may be needed. Once you do that, you are looking at some sort of crown as there will be a lot of tooth structure gone after decay removal and access opening for pulp therapy. We often do small or medium sized fillings on front baby teeth, although sedation or the like is sometimes needed to get adequate cooperation (not always needed though). It is a detailed procedure. You don't want the patient moving around too much or you will be into the pulp due to patient movement. It all depends on the size and depth of the cavity.

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Anonymous said...

Hi, My 9 year old son's 4th upper tooth ,1st molar is decayed. Our dentist said it needed a filling but when we went back for our appointment he noticed a small abscess so decided to refer him for an extraction. He also prescribed antibiotics, although my son has no symptoms and by the same evening the puss was gone. My question is does he need antibiotics? Is extraction really the only way? Also if sedation, which he said he'd need would be absolutely necessary? Finally, and most importantly, he was not offered a spacer, should he have been? Many thanks! Julia

Dr. Dean Brandon said...

In general, antibiotics help dental abscesses, reducing swelling, and making the area easier to do needed work, but they don't cure them. Removal of the offending tooth is what is done in most cases with abscessed baby molars. Spacers are needed (or not) depending on age, dental development and which tooth it is. Some 9 year olds do not need a spacer for first baby molars. Read more about space maintainers and sedation on the blog here.

Megan Lawrence said...

Dr. Brandon sent me to the Endodontist because my two front teeth which I broke two different times as a kid rollerskating the fillings that I had lasted a long time but they were dying So Dr. Brandon sent me to the endodontist.
I totally forgot who it was but any way the Endodontist will give you novacaine and because it takes a long process they put a block in your mouth for you to bite on. No it does not hurt like everyone says and goes on about it,but a rootcanal is worst then having a filling because it is sore from where they get all the dead stuff out afterwards but it is nothing compared to having all 4 wisdom teeth cut out at once. Thankyou Dr. Brandon I would rather have a rootcanal then have my tooth pulled.

Anonymous said...

hello
my 4 year old is schedule for two pulpotomy and 2 fillings this week under general anaesthesia.could u please tell me how they sedate the child and how long it takes th hild to wakeup after th whole procedure?

Dr. Dean Brandon said...

Those questions are best answered by the anesthesiologist. Most children I see in the hospital go home about an hour or two after the procedure is completed.

Anonymous said...

hi my query is quite same as above.3 year old with a pupotomy and a few fillings under GA recommended by a paed. dentist because my kid isnt co-operative.he had four fillings in bottom molars befor without any hesitation.the day i took him to the dentist wasnt one of the bests for him.after school,tired and cranky.
i just feel that if we give the kid a chance with 2-3 sessions,he will do well.
should i gt a second opinion as well?was just thinking n reading and thhought i'd ask.
thanks for reading!

Dr. Dean Brandon said...

Yes, please feel free to read here on the blog about how children behave and alternative treatment modalities.

If you think about it, most minor surgery takes place under general anesthesia. It's us dentists that have to work on awake patients most of the time. Many young children do well for short easy things. However, the more the work or the more intensive the procedures, the less likely the child will do well. --or, he will do well for only so long. It's a judgment call based on previous behavior, age, the type and number of procedures, temperment, personality, and the patient's past experiences. There are very few 3 year olds that will sit still for very long--depends on what side of the bed they wake up on that day.

Dr. Dean Brandon said...

Oh, just remember we are talking about high speed cutting instruments in a very small space. Excessive patient movement can be a dangerous thing.

Anonymous said...

hello,first of all..what a terrific job you are doing!it erases soo much of our concerns,specially parents with young children.
i need an opinion too...i took my DS 4 years old to a paediatric dentist after he complained of tooth ache. he prescribed pulpectomy for upper two (seond last tooths-towards the end) and put him on antibiotics(for a GA)next weekend.

i am oving to uk as my hubby is there in 10 days also.my question is how long do u think one can wait for a pulpectomy...does the infection spread quickly?i am getting mixed opinions here as people are suggesting me to wait and other half are suggesting to go for it????
my DS usually complainns every next day of a sharp pain,that goes off once i give him a teaspoon of paracetamol.

Dr. Dean Brandon said...

Really, most of the time an abscessed (baby) tooth needs to be removed and a space maintainer placed. Antibiotics buy some time and reduce the chance of spread of infection--also helps kids feel a little better. Most antibiotics are given for about 10 days but often seem to have a residual effect after that for a little longer than that.

Most of the time, if baby teeth are not abscessed, just inflamed and "sick", but not dead, we do pulpotomies not pulpectomies. (I know that's a fine distinction most people don't know about.) Rarely, we will try a pulpectomy on a baby molar to try and save it. So, I would go with a pediatric dentist's recommendations because they have seen the actual situation.

Megan Lawrence said...

Dr. Brandon after you have had a Root Canal, and it is in the process of a filling, cap, or crown, if a Crown is recommended more than a filling, then how long does a filling last? Just wondering if I needed to start thinking about a Crown for the front teeth or not.

Dr. Dean Brandon said...

A crown is "Usually" needed mainly because there is likely a lot of tooth structure missing due to decay and the endodontic access. There is also concern about leakage contaminating the root canal, but that is not as big a concern these days due to white fillings that bond to tooth structure. Now, for front teeth, cosmetics is often the issue. A really good filling may not cover the natural darkening that occurs in a "dead" tooth. A filling should last a long time there however if there is not much tooth structure gone.

Hehehaha said...

I was curious to the severity of my abscess, now I've had a reoccurring abscess before on a baby tooth when I was 12-14 eventually after poping it everytime it apeared it finally went away and it was removed at 18 I've had a crown in next to another baby tooth but this baby tooth is alot different it has an impacted permanant tooth under it as the other had nothing, this abscess is alot deeper about 1/4 in and my consern is damage of the impacted tooth, surrounding teeth or swelling of my face. I only have a small amount of pain to it and its only when I push on it, I also pop and sterilize it with peroxide. im wondering if this will disapear like my other one did or will these differences be a bigger problem. I'm also trying to post pone all medical needs until febuary, its december, because of my airforce overseas packet, I do not want to have to update it or further delay his orders. So is 3 months really that bad to wait, I've been having this issue for about 1 month or possibly 2. Thanx:)

Dr. Dean Brandon said...

A bump or pimple on the gum that doesn't go away, is often from a dead abscessed tooth. It can be other things too. A dentist should take a look. These fistulas do not go away till the tooth is removed or a root canal of some sort is done. Infection can spread into the face and can cause pain or other problems. Usually, however, it does not bother too much.
The military will likely do a complete medical exam, and I suspect will want dental needs addressed as well. Good luck and thank you for your service.

Whitening Guy Cardiff said...

I had a Triple Abcsess once, that was a problem as the whole side of my face swelled up.
I had an extraction and a titanium screw insert added. I have not had the crown fitted to date....is it possible this could have affected my bite symmetry?

Dr. Dean Brandon said...

Sorry that happened. This is really not something a Pediatric Dentist usually sees. I'd contact your general dentist.

rloftman said...

Dr Branson,
You blog is great. Thank you for taking the time to inform us all. My daughter (6 years old) had pulpotomy (or was it pulpectomy?) on her bottom first molar a year ago and it was like magic for a very paiful ache. Now it hurts alot my daughther thinks on the outside of the gum below that tooth. X-ray last Friday was negative, and we were sent home. Now her cheeck swelled up like a chipmunk, we started amoxocillin lat night, and this morning took a plano x-ray to see all around. Dentist thinks he sees a shadow under that tooth (subtle to me), but wants to avoid extraction (general anesthetia required, daughter can't hold still for proceedure), so recommends waiting to see if antibiotics can take care of it. I want to hear this conservative approach is not too risky! There are some real horror stories on web about untreated abcess. Thank you so much if you can respond!
Rick
(sorry if you get this twice, I had trouble figuring out the google login)

Dr. Dean Brandon said...

Usually, an abscessed baby tooth is removed and a space maintainer placed. A baby tooth with a pulpotomy usually does not abscess, or if it does, it is usually kind of low grade. A permanent tooth abscess is a differrent thing as you can read here. Antibiotics can help, but treatment of some kind is often needed. Sometimes it is the first thing you try if it is questionable. Good luck.

Vark said...

Hi there, My son has just seen the dentist and his 75 and 85 have extensive dentine caries (generally occlusal surface). He is 4 years old. In your opinion, would you A - place a restoration. B - do a pulptomy or C - do a pulpectomy. There is no abscess, no mobility and he has not complained of any toothache. I want the best option for the longevity of these teeth!!!

Anonymous said...

Thanks a lot! Greatly appreciate your inputs on my following questions.
I wish my son's dentist has this great professional attitude to explain these medical terms. My 4-yr old boy had many trips to the ped dental offices since Oct this year. A front tooth cavity->fillings->chipped&refillings a few times-> abscess two weeks ago and some antibiotic treatment. I was totally shocked by the dentist's tooth removal decision today, without taking a X-ray to see tooth conditions.
I decided not to

do it until hearing a second opinion. Since holidays are coming, it is hard to get appointed. How aggressive is this abscess? How long can we wait?

Dr. Dean Brandon said...

I can't diagnose over the Internet , but generally abscesses baby teeth are removed. Antibiotics may buy some time if a patient is comfortable and no swelling Still a dentist should follow an abscess. It can become more serious.

Dr. Dean Brandon said...

Vark--Every case is different and the dentist on the spot has to make that decision. Read my other posts on crowns, dental caries and restorations.

Anonymous said...

What are your thoughts about the unecessary procedures documented to have been done to children at Medicare mills like "Smile Center" - severe routines without sedation, parents not allowed in the back with their kids during extreme procedures, insistence on getting everything (12 crowns) in a single day at all costs, not using anesthesia, etc.

Medicare patients need to be educated on what's normal and what is not

Dr. Dean Brandon said...

That's a good question deserving a thurough answer. I will need some time to address this hot topic. Perhaps through a comment here or even a longer post. Check back here later.

Dr. Dean Brandon said...

There is a good deal of controversy about clinics primarily treating Medicaid patients. Medicaid is a government program designed for children up to about 18 years of age. So, as such many of these clinics give the impression to parents that the dentists are specialists in Pediatric Dentistry. This is usually not the case. This issue is addressed here in my previous post on the subject:
Is your dentist a pediatric specialist?

Other issues you site are unnecessary treatment. How do you know it is unnecessary? The only person who would really know are the dentist involved or any dentist who had access to all the appropriate information including x-rays and an accurate description of behavior during treatment caries history etc. Some articles cite a large number of stainless steel crowns placed as reason to suspect unnecessary treatment. It is my observation that Medicaid patients in most any setting may receive a slightly higher number of stainless steel crowns. Is that unnecessary--not necessarily. Many children in poor communities have higher caries rate, wait longer to receive treatment (ie. the cavities can be larger or deeper), and often do not seek followup preventive care. In other words crowns are more likely to be indicated than the general population. Still, there is a question still out there, and I do not have the ultimate answer.

Restraint or difficult behavior management was alluded to in your question. Many children, due to age, or extent of treatment, do not respond well to long periods of dental treatment. They are often very young. There are ways to manage patient's behavior where they can obtain care with minimal problems or distress. These methods I have outlined in this blog many times and include such things as specific verbal cues, conscious sedation or general anesthesia. Thus, I come back to the previous paragraph. Many dentists treating medicaid children are not pediatric dentists and have not been trained to safely administer sedation or are not trained or certified to do these cases under general anesthesia. Restraint is not always a bad way to accomplish quick treatment on very young uncooperative children, thus avoiding the risk of the medications used in sedation or the risk of hospitalization. Sometimes a cooperative child becomes uncooperative right towards the end of treatment and it is difficult to leave a procedure half completed. This is a very complicated and emotional topic.

It is always my opinion that parents should be allowed back during treatment if they should so desire. This is the policy at our office. I will say, it is not always the best idea as children often do much better without a hovering parent in the room. (again a controversial subject I addressed in a previous post).

Th root of the problem is that Medicaid is a government program that has many problems. I does allow many poor children to receive needed treatment. Unfortunately, very low reimbursement levels were cited by dentists as the number one reason they do not even take medicaid. Frequent missed appointments was another. Some state's plans are so bad, dentists are basically loosing money seeing medicaid patients unless they do a very large number of procedures with little time for patient/parent interaction. It is a definite real problem of access to care. Of course, these patients are not really denied access. It's not that these dentists actually deny an appointment, it is that the parents choose to not to bring cash for payment. They would understandably rather choose to continue to look for another a dentist who would accept their medicaid.

So, as to your premise, that all the Medicaid mills are bad, to that I cannot say, but there is a great concern in the pediatric dentistry community that things are not being done correctly for these children.

Anonymous said...

What if you are an adult with some infection, no pain, under baby tooth -- had no permanent tooth that is. Would you try to save the baby tooth or pull it and put in an implant? I'm now on antibiotics for the infection but now what...

Betnmike said...

My 6 year old had a baby root canal last April, the filling came out so I took him to the dentist to get a cap during the procedure he said there was a lot of decay in the pulp and not much of the tooth was left so he recommended pulling the tooth and getting a spacer. He pulled the tooth no problem but he could not get the root out. Now here is my question, is it necessary to remove the root with an oral surgeon or will it dissolve on its on?

Dr. Dean Brandon said...

Sometimes you can leave a small piece of root if it is very difficult to get. With baby teeth that part Usually resorbs or dissolves as the new tooth erupts.

Dr. Dean Brandon said...

Well,over 50 comments here, so I am halting comments here. There is lots of info in the post and in the comments already posted.

Dr. Dean Brandon said...

Anon. Sometimes baby teeth can last a really long time, but if they are abscessed you need to consult your dentist to see what your options are. One could be removal and placement of an implant.