Vital pulpotomy usually is done in children when decay has reached the crown part of the pulp, but the nerve in the root of the tooth is still healthy. The procedure also is done when the pulp is exposed as a result of injury or trauma. The affected part of the pulp can be removed, leaving the healthy part in the root.
A successful vital pulpotomy relieves sensitivity and pain. It also prevents the supporting tissues around the tooth from breaking down.
For your dentist to do a vital pulpotomy, the tooth should not be loose or have any swelling or abscesses around it. If there is swelling or an abscess, another type of treatment may be needed.
Vital pulpotomies can be done in children's baby teeth (primary teeth) or in young permanent teeth. In primary teeth, the procedure is done to keep the primary tooth from being extracted. Extracting a primary tooth before it is ready to fall out can alter the way the permanent teeth come in and may cause problems in the future with the child's bite.
If the pulp of a permanent tooth becomes injured or decayed soon after it emerges, the tooth may require root canal treatment. However, root canal treatment is not done until the tooth's roots are finished growing. In this case, a vital pulpotomy can be done instead. Root canal treatment can be done after the roots finish developing.
A vital pulpotomy is done with the patient under local anesthesia. Sedation also may be used. This can include nitrous oxide or an oral medicine. Sedation may help to calm anxious children or young children who are not able to cooperate.
The dentist will check on the tooth during future visits.
Some of the medicines used in vital pulpotomy can irritate tissues outside of the pulp. Your child might feel a temporary burning sensation in the area of the affected tooth.
If the tooth's entire nerve is infected, the vital pulpotomy may fail. Your dentist will look for infection during the procedure, but if the nerve is in the early stages of infection it may look healthy.
If the tooth still hurts after a vital pulpotomy, root canal treatment may be needed. This will be done to remove the rest of the affected pulp.