Kids and teeth: Pulpectomy, pulpotomy

[coffeeseven]

Pulpotomy: The removal of the top part of the pulp inside a tooth.
Pulpectomy: he removal of the whole pulp inside a tooth.

Gross I know. When you're a parent you get an education in things you never thought you would would have to.

A friend of mine had a 4 year old boy that had to have a "pulpotomy". It's a mini root canal that takes only the top portion of the pulp inside of the tooth. Then they put a stainless steel cap on it. Happy happy. That child has developed allergies and sensitivities that he didn't have before. We all assumed it was the metal cap.

My daughter now has to go in for the same thing. I did some searching and found out that when the dentists rout out the tooth, they introduce "Formocresol" to kill all of the bacteria and the surrounding interior tissue.

Formocresol is basically a formaldehyde compound that causes chemical sensitivities and cancer. We thought it was the metal that caused the problems. NOT!

Not wanting to get too deep. Just a FYI to the parents out there.

Ferric Sulfate is the current safest replacement.

[Beth221]

Formocresol when applied, is then dried with air, and it evaporates, that is what kills the bacteria, if the dont kill the bacteria, it gets trapped and causes further decay. 

i have had both a pulpo and a pulpec, when i was a kid.  I have assisted in them too, and i have seen what happens when either its left untreated, or the tooth is removed, and not replaced with a space-maintainer.  Messes up the adult teeth. 

the reason for the 'mini root canal" is because the nerve is contaminated with bacteria, from decay, it is an active infection, which can lead to death if untreated.  a few years a go, a cute 7 yr old died from a rotten tooth. 

The stainless steel cap, which is a temporary crown its on a base material, and is not in contact with the nerve.  You can request a acrylic material, a plastic one, if you dont want stainless steel. 

You can request that an etch be used instead of the Formocresol, it does the same thing, both help the core materal bod, so the crwon can be placed. 

[Faber]

I don't see what the problem is.  According to The Secret, you just have to ask for your tooth to be fixed, believe it's already been fixed, and then receive the fixed tooth from the universe.  And if that doesn't work, you can just ask for the cap to have no adverse effects, believe that it will have no adverse effects, and voila! you receive from the universe what you want: no adverse effects.

Your negative attitude is the problem here, coffee.  Positive thoughts, you've really got to believe!

[coffeeseven]

Thank you Beth. It's alway nice to get an informed opinion of someone who has seen both sides of the chair. 

I was reading a 2005 issue of the Journal of the Canadian Dental Association that quotes a 2003 study in the UK. 54% of the dentists surveyed expressed some concern over the

possible sensitization, toxic, mutagenic or carcinogenic effects of formocresol; 42% of specialists surveyed in 2002 were considering changing their pulp technique to avoid formocresol

http://www.cda-adc.ca/jcda/vol-71/issue-10/749.pdf

I think with those numbers in mind I will ask if ferric sulfate is a possible substitute. I am also going to ask if the bonded composite is an option.

I'd like to hear more about the "etch". I probably won't get your response before we have to go but the information may help in the future.

[Beth221]

goo luck finding someone to use a bonded composite in a childs tooth, the retention sucks, and they leak, i have never seen any dentist do that. 

as for core materials, they leak,a nd are not IDEAL for buildups, post and cores, or endo-fills.

they are, however, good for single occusal fillings, where they can be watch for leaking, for multi-surface fillings, or large fillings, you need xrays every 6 months, because they leak that bad, and they need to drill out more of your tooth for retention.


btw, we were having an interesting dental, and replacement, (haha) conversation, on the thread, who can the army not PISS off, er dsomething that like that! 

I personally, for a childs tooth, if amalgam is not your thing, ask for a material called Ketac (pernounced key-tac) Silver, its a glass ionimer material with silver fillings, and can be available with flouride, which can help an injure tooth like this one, be stronger, espcially after stress.

get in touch with me, if you need any help, i would be happy to look over any xrays for my offical, non-offical opinion.

is your child going to a specialized childrens dentist?  I reccomend any child go see one, because they treat just kids, and do these things every day, a general DDS doesnt do many, its like having a plastic surgeon who mostly works on faces, rebuild your knee.

good luck! 

[MaineShark]

is your child going to a specialized childrens dentist?  I reccomend any child go see one, because they treat just kids, and do these things every day, a general DDS doesnt do many, its like having a plastic surgeon who mostly works on faces, rebuild your knee.

Slight hijack... do you know of any good pedodontists in NH?  Particularly, the greater Concord area?

Little guy needs to have his teeth checked...

Joe

[kola]

I didn't know she was a dentist. 

Kola

[kola]

Beth: Formocresol when applied, is then dried with air, and it evaporates, that is what kills the bacteria, if the dont kill the bacteria, it gets trapped and causes further decay. 

According to coffee7's comments, Formocresol has more specific side effects (bone necrosis, CA etc) than just "further decay". ..and the fact that almost half of the specialists believe it should not be used definitely says a lot.

Dr. Beth, Do mercury fillings leak?

Are you qualified to read x-rays too?

Kola

[Beth221]

yes, I am certified in dental radiology.

Over many years, amalgam fillings will leak, if you dont floss and brush, like your car, your teeth needs maintenance.

Formocresol- the reason why it is used is because it is a strong antibacterial, when it evaporates, that is when it kills the germs, it goes into the organisms, and evaporates, killing a broad spectrum of germs.  If you dont kill the bacteria, it will lead to decay, because the bacteria will start eating your tooth, causing decay, or cause an infection, which may lead to death if left untreated.  The bacteria causes the decay not the Formo.

Kola, It is my professional opinion that you brush your teeth, after every meal, and floss too, after every meal, and then you wont need amalgam fillings.

Ivy, and Angry Joe (hehhee) best thing you can do, is when your child starts getting teeth in, is dont send them to bed with a milk baaba, you want something sugar free, if not water.  Milk is very high in sugar, along with fruit juices, and sport drinks.  WHen sleeping, the saliva flow is reduced because your body is at rest, there is less swallowing, which cleans and flushes the mouth naturally.  So, if you fill the bottle with milk, and send little one to bed, the sugar in the milk sits on the wee little teeth, and it feeds the bacteria, giving it a sugar rush to feed on teeth, which will cause caries, cavities, decay. 

For little totes, there is a starting out tooth paste, that is fluoride free, if you have Fl2 in your water, then there is no need for extra in pastes, and rinses.  Fl2 is a trace mineral, which the body requires on a TRACE amount.  We tend to over do it here in the USA.  If I dont have fl2 in my paste, in 6 months i will have a small cavity.  I must require a little more, i have it in my water, but i dont drink tap water.  Fl2 reminerializes your teeth, on a microscopic level, sealing the pores of the enamel of your teeth, like your skin your teeth have pores.  Without Fl2 (again, trace amounts) the pores are open, and can let bacteria inside to cause decay.

Since we are talking childrens teeth, about sealants-it is a liquid plastic that is applied wet to a tooth, and dried with a UV light.  We pumice the teeth, acid etch them, to kill bacteria, dry, and apply the sealant.  We apply it to the grooves of the teeth, and it flows deep into the groove, sealing it, we do this because a tooth brush bristle is too large to get into the groove on a microscopic level, where bacteria can reach.  If you teach your child good brushing habits, and has no history of getting rampant decay (which can be cause from medications while teeth are forming, not just bad brushing habits) (rampant, out of control, every tooth needs a filling, has decay..) then you dont need sealants like the 12 yr old boy who doesnt brush.  I dont know why, but teenage boys never brush, and girls have better hygiene habits! 

did i miss anything?

If Rainy was around, i helped her too, and I think she took my advice, found agreat dentist who was impressed of her knowledge, she can tell you if my advice was good or not!

B 

Part of my job, kola in the dental field, is to read, and pre-diagnose dental conditions, and report my findings. 

[MaineShark]

Ivy, and Angry Joe (hehhee) best thing you can do, is when your child starts getting teeth in, is dont send them to bed with a milk baaba, you want something sugar free, if not water.  Milk is very high in sugar, along with fruit juices, and sport drinks.  WHen sleeping, the saliva flow is reduced because your body is at rest, there is less swallowing, which cleans and flushes the mouth naturally.  So, if you fill the bottle with milk, and send little one to bed, the sugar in the milk sits on the wee little teeth, and it feeds the bacteria, giving it a sugar rush to feed on teeth, which will cause caries, cavities, decay. 

For little totes, there is a starting out tooth paste, that is fluoride free, if you have Fl2 in your water, then there is no need for extra in pastes, and rinses.  Fl2 is a trace mineral, which the body requires on a TRACE amount.  We tend to over do it here in the USA.  If I dont have fl2 in my paste, in 6 months i will have a small cavity.  I must require a little more, i have it in my water, but i dont drink tap water.  Fl2 reminerializes your teeth, on a microscopic level, sealing the pores of the enamel of your teeth, like your skin your teeth have pores.  Without Fl2 (again, trace amounts) the pores are open, and can let bacteria inside to cause decay.

Yeah, he gets his teeth brushed every night before bed.  Used to complain, until we made a game out of it (she brushes his teeth while I'm brushing mine).

And yes, some trace fluoride is a good thing.  It's a good thing to have on your teeth, just not drinking it in the ridiculous quantities they put in public water.  I use ACT, which seems to keep things working well, and I spit it out when I'm done, instead of swallowing it like public water...

Joe

[Beth221]

plus 1 karma for brushing your teeth joe!

[kola]

so you are not a dentist?

Kola

[MaineShark]

plus 1 karma for brushing your teeth joe!

That whole "lydocaine doesn't work on me" thing gives me good incentive to stay out from under the drill.

Plus, who wants to kiss someone with bad breath!

Joe

[Beth221]

Joe, i must say, that is RARE. 

you must have a strange location of your mandibular nerve!

have you tried carbocaine, or zicaine? 

Oral/maxliofacial surgeons have stronger anethesia they use, because it shrinks blood vessels temporarily, so they can work in a blood free area, and it will make you numb for days!!

Can your top teeth get numb?  or none?  Maybe your bone is denser than normal, bone for the top teeth are porus, so lidocaine can be absorbed to make the tooth numb, whereas, the bottom, we must do a full mandibular nerve block, because the bone in the jaw is dense. 

[MaineShark]

Joe, i must say, that is RARE.

Yeah.  Dramamine causes motion sickness for me.  That's rare, too.

you must have a strange location of your mandibular nerve!

have you tried carbocaine, or zicaine? 

Oral/maxliofacial surgeons have stronger anethesia they use, because it shrinks blood vessels temporarily, so they can work in a blood free area, and it will make you numb for days!!

Can your top teeth get numb?  or none?  Maybe your bone is denser than normal, bone for the top teeth are porus, so lidocaine can be absorbed to make the tooth numb, whereas, the bottom, we must do a full mandibular nerve block, because the bone in the jaw is dense.

I've had work on upper and lowers.  The stuff gets my teeth numb for like five minutes, then wears off.  Not worth the trouble.  Prophylactic care seems a better plan, personally!

The only analgesic I've tried that has any significant effect is aspirin, interestingly enough.  Or some of the natural remedies which use similar active ingredients.

Joe