Pulp Capping For Baby Teeth: An Alternative To Root Canals

At the center of each of your teeth, you'll find the tooth's nerve (which is often called the pulp). The pulp prefers a hermit-like existence and should have no contact with the outside world. The pulp chamber is protected by your tooth's structure (made of dentin and the outer enamel) but is still vulnerable. When an adult's dental pulp becomes irreversibly infected, you'll need a root canal to remove this pulp. Is it the same when a child's primary baby tooth faces an infection of its pulp?


It's typically a form of bacterial contamination that attacks the pulp. This may be due to a cavity that stretches from your enamel inwards towards the pulp. Infection is also possible via a cavity on the tooth's root, or due to periodontal disease. For adults, irreversible pulpitis triggers a root canal. The inflamed pulp is removed before the chamber is filled with biocompatible latex. The tooth is then restored with a filling (and often a dental crown as well). This process allows the tooth to remain intact and firmly anchored in your jaw. Primary baby teeth, which will eventually detach as replacement adult teeth develop beneath them, are a different matter.

Dental Exfoliation

Restoring a baby tooth with pulpitis requires a different approach. A root canal is intended to be a permanent solution, which makes little sense on a tooth that isn't actually permanent. Any disturbance to the tooth's roots can also disrupt dental exfoliation, which is when the baby tooth's root system is progressively dissolved by the crown of the adult teeth erupting beneath it. This is why root canals are rarely performed on baby teeth. Pediatric dentistry has a far more suitable solution, and this is called pulp capping.

Pulp Capping

Indirect pulp capping is the preferred method and can be used when the pulp chamber is still protected by a layer of the tooth's dentin (however thin and weak this layer might be). The dental pulp is inflamed, but the damage is not yet irreversible. The remaining layer of dentin is then reinforced with a barrier made of mineral trioxide aggregate or calcium hydroxide. The weakened dentin is remineralized by this protective barrier. The body's immune response then triggers the production of tertiary dentin, further reinforcing the artificial barrier added by your child's pediatric dentist. A temporary filling is then added to the cavity. After enough time to allow sufficient tertiary dentin to form, the cavity will be re-examined. The original layer of weakened dentin will be removed, with the artificial barrier and newly-formed tertiary dentin now securely protecting the dental pulp (which should no longer be inflamed).

Pulp capping allows a child's tooth to remain healthy until dental exfoliation occurs while sparing them from the potentially invasive (and unnecessary for children) experience of undergoing a root canal.

For more information on pediatric dentistry, contact a company like New England Dental Specialists of Norwood.