If your child’s primary tooth has extensive decay, or has been damaged by trauma, action may be needed to restore the integrity of the tooth and prevent infection from spreading to surrounding teeth. After a set of X-rays are taken, your endodontist will be able to assess the extent of the infection and recommend one of two options, a pulpotomy or a pulpectomy.
If the decay or trauma is confined to the crown of the tooth, a pulpotomy may be recommended. When a cavity gets really deep, close to the pulp of a tooth, or even into the pulp, the pulpal tissue becomes irritated and inflamed. A pulpotomy is when the inflamed pulp chamber, usually on a baby molar, is removed. The endodontist will remove all the infected material in the pulp of the crown only, leaving the living tooth root intact. After a pulpotomy on a baby molar, the empty space will be filled with dental cement and a stainless steel crown will be placed to restore the tooth.
If the infection involves tissue in both the tooth crown and the tooth root, a pulpectomy may be the best option. In a pulpectomy, the entire pulp material is removed from both the crown and the roots. After numbing your child’s tooth, the endodontist will remove the pulp and nerve tissue from the crown and from the canals of the roots. Then, the pulp chamber and root canals will be thoroughly cleaned and disinfected. Next, the dentist will fill the tooth and tooth roots with a dental cement, and finish with a stainless steel crown.
Crowns are "cemented" onto an existing tooth and fully cover the portion of the tooth above the gum line. In effect, the crown becomes the tooth’s new outer surface.
Stainless steel dental crowns are considered a good temporary restoration to save a primary tooth until the permanent tooth can erupt and take its place. Keeping the primary tooth if at all possible is very important. A primary tooth can be restored with a stainless steel crown during one appointment. A crowned tooth must be brushed and flossed just like other teeth.