Endodontic Treatment In Children

Endodontic treatment involves involves the nerves and blood vessels in the center of the tooth, called the pulp.

Symptoms that may indicate a need for endodontic treatment include:

  • Pain from a tooth during the day or night for no apparent reason
  • A tooth that is highly sensitive to temperature changes
  • Sensitivity from a broken tooth with exposed pulp

Even though baby teeth eventually will fall out, your dentist will suggest repairing them unless they are going to fall out soon.

Primary teeth are needed for chewing and speaking, as well as to hold proper spacing for the permanent teeth that will eventually replace them. If your child loses a primary tooth too soon, neighboring teeth can invade the space, blocking the permanent tooth from coming in, or cause it to grow in tilted.

The type of endodontic treatment required depends on how seriously the pulp is affected. Treatment is based on your child’s history of pain, examination of the teeth and X-ray results

There are two categories of pulp therapy, depending on whether the pulp is healthy enough to be saved. Vital pulp therapy preserves and protects the tooth’s pulp. Nonvital pulp therapy, also called root canal treatment, removes the remnants of a diseased pulp, but maintains the tooth and its functions.

. If the health of a tooth cannot be maintained by either of these methods, the tooth must be extracted.

Vital Pulp Therapy for Primary (Baby) Teeth

For vital pulp therapy to be successful, there must not be any swelling or abscesses, and the affected teeth must not be loose. If there is swelling or the tooth is loose because of an abscess, it will have to be treated with root canal therapy or extracted unless it is going to fall out soon. If the tooth needs to be extracted, your dentist will talk to you about other methods to preserve the space until the permanent tooth comes in.

Non-Vital Pulp Therapy for Primary (Baby) Teeth
Non-vital pulp therapy, better known as root canal treatment, is done when the pulp in the tooth is too damaged by decay or trauma to be saved. The dentist removes all of the pulp from inside all parts of the tooth, cleans the root canals and fills them with a specially formulated material. The material is designed to be absorbed while the body naturally reabsorbing the root in preparation for the tooth falling out to be replaced by a permanent tooth. A stainless steel crown is placed on the tooth to keep it from fracturing. If the tooth is in the front part of the mouth, the stainless steel can be covered with a tooth-colored facing

Non-vital pulp therapy usually requires more than one visit.

Primary Teeth: Root Canal Treatment Versus Extraction
Your dentist will give you information so you can decide whether to extract a primary tooth and place a space maintainer if needed to preserve spacing or perform root canal treatment. Factors that affect this decision include:

  • Which tooth is affected
  • How much longer it is needed
  • The amount of damage
  • Whether the problem has affected neighboring bone and gum tissues
  • Whether the tooth can be repaired adequately after completing the root canal treatment

If your child is healthy and removing the tooth might affect your child’s ability to eat or speak properly, or the permanent tooth’s ability to come in properly, your dentist may encourage root canal treatment

After Endodontic Treatment
Your child may have some soreness after endodontic treatment and between visits if more than one visit is needed. The discomfort is short-term, and can be managed with over-the-counter pediatric pain medications.


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