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When decay in an adult tooth gets very deep or progresses into the pulp (the nerve), a root canal is indicated. Similarly, when decay in a primary or “baby tooth” progresses that far, or is into the nerve, a baby root canal is indicated. However, the similarity between adult and baby root-canals ends there.
The goal of a baby root canal is to preserve the baby tooth long enough to hold space for the adult teeth that will erupt as your child’s teeth develop. If a child loses too many baby teeth, teeth can shift and block the eruption path for the adult teeth. If this situation occurs we can treat it with a space maintainer, but we’d much prefer to maintain the baby teeth at least until the adult teeth erupt.
A root canal on a baby tooth is often referred to as a pulpotomy or pulpectomy, and while these procedures are not the same, you may hear these terms used interchangeably. The procedure is performed under local anesthesia (the same numbing that we use when we do a traditional filling) so your child will not feel discomfort.
We do not use files on primary teeth as we do on adult teeth because using files runs the risk of damaging the adult teeth that are present underneath the baby teeth. Instead, we remove the top portion of the nerve and freeze the remaining nerve with a fixative material in order to make the nerve non-reactive, and to minimize the chance that the child has discomfort. We then place a layer of medication in the tooth and we restore the tooth with a stainless-steel crown. Many parents ask us to place white fillings or tooth-colored crowns on baby teeth with root canals, and we generally do not do that because a stainless-steel crown is the recommended restoration for a tooth with a baby root canal.
If you have any questions about baby root canals or why we use stainless-steel crowns, please don’t hesitate to ask!
