Dentistry Answers For Dentists Ask Other Dentists Questions about Problem Dentistry Issues

Home	Map	Ask The Dentist	FAQ's	Polls	Current Research	Consultants	News	Schools	Directories	Jobs	Library
Click HERE to use Dental Health Search to Find a Dentist or more Dentistry research information

Dental Health Directory Library

FAQ Category: Dentistry Answers for Dentists

Dentists Ask Dentists - Problem Dentistry Lance Timmerman

Topic: Pulpotomy
Question:
Hi, I'm a general dentist seeing a lot of young patients. I generally get a lot of them with abscess after their primary teeth have had pulpotomy.

My questions is how often does that occur? That is if a tooth has had a pulpotomy. Is it a common occurrance or procedural error? Thank You. ... Dentist from Washington

Answer:
As you know, when a primary tooth has gone south, we are trying to be heroic and save the tooth long enough to allow the permanent tooth to come in. The question is what are we working with? Is the tooth vital or necrotic? If the pulpotomies are failing, then the teeth were already necrotic and the abscess was inevitable. It may have been better to have done a pulpectomy instead, but then if insurance is a factor, they won't pay for pulpectomies (or partial root canals) on primary teeth. If you have a laser, you will have more success with these teeth.

Pulpotomies are a form of endo, incomplete by nature. If the tooth abscesses afterwards it could be an operator error or just normal (accelerated) exfoliation. Many of these teeth are far gone when you see to begin with and if they were a permanent tooth you may have extracted it.

It is not as big an issue as you might assume. You are only trying to maintain space during the time of eruption of the permanent teeth. When you see a pulpotomy fail you will generally see earlier eruption of the permanent tooth since the abscess will uncover the bone overlaying the permanent tooth.

The best space maintainer, hands down, is a natural tooth. The pulpotomy is just you trying to use the tooth as a space maintainer. Worst case? .. regular space maintainer, band and loop or crown and loop. So what? You tried to avoid it and it didn't work out. All dentistry in every form is just our best efforts with different levels of success rates, but NOTHING is 100% successful.

My guess is there is no operator error here.

Lance Timmerman, DMD
7100 Fort Dent Way, Suite 270
Seattle, WA 98188
(206) 241-5533

Return to Dentist Ask Dentists Category

Return to FAQ's Main

Ask a Professional Question

[Home] [Ask The Dentist] [FAQ's] [Polls] [Consultants] [Directories] [Employment] [Library]
Contact the Editor

Dental Health Directory
Ask The Dentist
Featured in