Children with cavities often do not complain until they get really bad. Unfortunately, sometimes by the time a child begins to feel discomfort from a tooth, the cavity has become so large that it extends into the nerve deep within the tooth. Although even very large cavities such as these can be restored, successful restoration now requires treatment of the nerve as well as the tooth structure outside.
There are two types of nerve treatment in primary teeth. A pulpotomy involves removal of the nerve in the top portion of the tooth, leaving the nerve in the lower portion of the tooth undisturbed. Following removal of the top part of the nerve, the tooth is disinfected and a restoration (usually a stainless steel crown) is placed to keep the tooth strong and healthy. A pulpectomy involves the complete removal of all nerve tissue inside the tooth (a baby root canal). Once the nerve tissue is removed, the inside of the tooth is disinfected and an antibacterial filling material is placed within. A restoration (usually a stainless steel crown) is placed on top.
Often pulp therapy and the final restoration can be performed in a single visit. However, if a severe dental infection requires additional time to clear, Dr. Lam may recommend treatment such as this take place over two or more visits.