any ped. dentists answering tonight?

Question

My daughter(age 5) has two cavities,in her back molars.The dentists wants to do A root canal on both.Why not just pull them, she will lose them anyways. right?Her appt. is Tues.please help

Answer 1

The procedure is called a pulpotomy, which is a child's version of root canal. It is a much quicker technique. The dentist removes the tissue from the root canal of the baby tooth (Yes, they DO have roots until they are ready to be shed when the roots have disolved.) and fills it in with a special cement made for this purpose. The tooth is then restored with either a simple filling or, if there has been a lot of breakdown, a pre-formed (inexpensive) stainless steel crown.

I'd say, the younger the child, the greater the indication for doing a pulpotomy. The purpose of this is to save a tooth rather than have it removed. Baby teeth DO serve a purpose, you know. The child uses them to eat with. On top of that, they will maintain the space that is needed for the permanent tooth to fit into the arch.

If you don't have the pulpotomy performed, the tooth will eventually hurt like heck, as the pulp (nerve and blood vessels inside the tooth) are already inflamed and probably infected. An abscess can pop up very quickly in a child. An infection (the abscess) can cause discoloration or even deformity of the permanent tooth.

If you decide to have the tooth taken out, especially at a very young age, it is very likely that the arch space will close up and there will not be room for the permanent tooth to come in. It is rather common to see a lower premolar growing in with the crown pointed half-way towards the tongue after one of the baby molars was removed at an early age without being replaced with a space maintainer.

If there is already an abscess showing in the mouth and if the x-ray shows that the bone between the roots has already been destroyed, a pulpotomy has a lower chance of success. Since this can happen in a matter of days in a child, do not delay treatment once it has been recommended.

http://dentalresource.org/topic57pulptherapy.html

Answer 2

It depends which baby molars we are talking about, and the type of treatment possible:
A pulpotomy (or partial RCT) involves the removal of the top part of the nerve (pulp chamber), and preservation of the nerve within the roots. This is appropriate for baby molars that are still alive ("vital"). It has a good success rate.
A pulpectomy (or full RCT) requires the removal of all the root contents as well, and is used where the nerve is dead and infected. The success rate is fair, and not often performed even by paedodontists here in Oz. An extraction is a reasonable option in such a case.
The first baby molars (4th from front) can be removed with little consequence for later teeth, but loss of the 2nd baby molars (5th from front) will lead to serious crowding problems unless the gap is held open with a space maintainer supported by the 1st adult molar. Your daughter will not have her adult molars yet, so space maintainers would be made up in a year or two.
It might be good to talk these things over with the dentist again to clarify exactly what and why he has chosen his proposed treatment. If in doubt, seek an opinion from a paedodontist.

Answer 3

the primary tooth acts as a guide for the adult tooth, pulling it will throw off the balace of the jaw and her teeth may come in crooked. Plus, she only has 8 molar at this age, she needs them all for chewing. Pulling teeth is a last step procedure that is only used when nothing else works.

Answer 4

Listent to Dr. Sam, he knows what he's talking about.