“Root canal on a baby tooth?”

Depending on your son's age, it may be important to save the baby teeth especially if the tooth is a back tooth or molar. In addition to giving children more teeth to with which to chew their food, keeping these baby molars saves space for the erupting permanent teeth and often prevents a more complex orthodontic problem in the future. Most importantly, the baby tooth needs to be treated to prevent infection. Often, a dentist may do a simple pulpal treatment on baby teeth instead of a full Root Canal like on permanent teeth. This is called a Pulpotomy. So, the real decision about pulpal treatment needs to be made on how long the tooth will be in place and evaluating the possibility of infection. Removing the tooth is sometimes an option but may not be the best option.

Dentist called baby root canal’s to pulpotomies which are the same concept but not the same procedure. The “baby root canal” takes coronal portion of the pulp (Which is the heart of the tooth) and replace it with a biocompatible material until the tooth falls off. The reason is because either the cavity of your child’s tooth has gotten too deep and even if he’s not feeling any pain, when cleaning up the cavity it can get too close to the pulp and even causes pain and even infection. We should never pull out a tooth unless it is because of an infection or failure to fall off on its own, the are vital to guide the permanent teeth into the right place, preserve space for these and are the foundation for healthy permanent dentition.

Baby root canals are sometimes necessary in order to maintain the health of the tooth and patient overall. Although most baby teeth will be lost and new ones will follow depending on the age that the baby tooth is lost can have some implications on the child’s development. Baby teeth in addition to providing chewing ability preserve the space for the developing permanent teeth. Sometimes when a baby tooth is lost early it can cause space
Loss as well as other problems for the permanent teeth developing underneath. Lastly although baby teeth will eventually exfoliate, baby teeth that develop “cavities” can develop more sever infections.

The quick answer is maybe.......sorry , but you did not mention your child's age nor location of the tooth :(

Primary tooth root canals are certainly acceptable treatment to preserve the tooth and the space it is maintaining for the permanent tooth that is due to follow it into the mouth. posterior teeth (molars) do not usually come in and out until 11 or 12, so a pulpotomy (most common type of baby tooth root canal) will preserve the tooth until that time. Alternate treatment could be extraction and space maintainer.

By not doing either the 'root canal' or extract and spacer there is the distinct possibility of the tooth abscessing, which i am sure you do not want to take the chance of happening to your child ;)

The first question is how old is your son. Usually root canal therapy is recommended for a baby tooth which has decay near or into the nerve of the tooth because the adult tooth is no way near ready to grow in. Saving the baby tooth is to help maintain the integrity of the arch and to hold the spot for the adult tooth when it is ready to grow in.

Some baby teeth are very important for growth and development. Especially the baby teeth in the back of the mouth. They are important because they hold the space for the adult teeth underneith them. If they are lost too early a child can experience space loss where the tooth behind the baby tooth that was lost moves forward and blocks the eruption of an un-erupted adult tooth; that may require orthodontic treatment to fix. If an important baby tooth is untreatable and has to be extracted early the best preventative treatment is to place a space maintainer to hold the space until the adult tooth erupts. Additionally, if a cavity is left untreated the baby tooth can get infected and damage adult teeth that have not erupted yet. In many cases the best treatment is to do something called a pulpotomy (some people call it a baby tooth root canal) to save a baby tooth to prevent future problems that are much harder to solve. I hope this helps.

Root canal on a baby tooth or pulpotomy, is necessary if the decay has penetrated the nerve. Most of the time these are performed on posterior teeth which need to remain in a child's mouth until between the ages of 8 and 12. Depending on your child's specific circumstances, the dentist is probably looking to keep the tooth for as long as possible to avoid space loss if the tooth is left untreated and needs to be removed. It is definitely not over the top.

There is a big difference between a "root canal" that is done on permanent teeth and a "pulpotomy" that is done on baby teeth. A root canal may take and hour or two, is very invasive and is used to preserve an adult tooth. A pulpotomy is used to save a baby molar. 

A pulpotomy is a 5 minutes procedure that involves removing part of the nerve and putting some medicine inside the tooth. Generally a pulpotomy is done when the cavity is close to or into the nerve of the tooth. If it is not done, the tooth may get infected. From experience kids usually get an agonizing toothache Friday at 6 PM when it is nearly impossible to find a dentist for the weekend. If a baby tooth becomes abscessed the best usual treatment is extraction. There is a misconception that an early extraction is OK since it is a tooth that will fall out anyway. Commonly if a baby tooth is lost prematurely, the other teeth move together and there is less room for the permanent replacement tooth to come in the future. This can cause a major and expensive orthodontic problem. In short, a pulpotomy may be the best way to keep a baby tooth out of pain until it is the right time for it to fall out.

Marc D. Thomas DDS

There are factors to consider here. You are correct that it will come out anyway. However if there is a significant problem needing root canal or pulpal treatment then the options are to treat or extract the tooth. Leaving an untreated problem could result in an abscess or even more significant facial infection. Depending on the tooth in question, dental age of the patient a space maintainer may be required if the tooth is extracted. We start losing our primary teeth around 6 but the process continues till we are 11 or 12.

It all depends on how old your child is... if he is going to lose the tooth within a year then it is better to just pull the tooth, but if he will have that tooth for another few years (molars don't fall out til the age of 11-14) then it is better to save that tooth. After a baby root canal is done, then a baby crown is recommended to maintain the structural integrity of the tooth

Baby teeth are used for chewing and to hold space inside the mouth while the adult teeth develop. Sometimes baby teeth need to be preserved because the adult teeth are not yet ready to erupt. Premature loss of baby teeth can result in loss of space inside the mouth and future orthodontic complications.

Yes, sometimes RCT is needed on baby teeth.

Hello,

This is a common question asked. The main purpose of the baby teeth is to maintain the space and allow for the permanent tooth to erupt in the correct position. So, if a root canal is treatment planned, the only other option is to pull the tooth. Depending on your child’s age the permanent tooth may erupt years down the road, so in the meantime you will need to place a space maintainer. Lack of direction and late or early ectopic eruption can result in costly orthodontics, etc., so it’s usually easier, cost effective to save the tooth albeit with a pulpotomy, root canal for baby teeth. Pulpotomies are not are cumbersome as a root canal for adult teeth. The main issue in pediatric dentistry is behavior management.
Hope this helped.

Good question - and I have two follow up questions - how old is he and when is he going to lose the tooth - and you may not know the answer so I can help! It sounds like your son has a large cavity in his baby tooth - I am guessing it is a molar as that is more common and likely the case given your description. Depending on how old your son is, he might not naturally be supposed to lose that tooth for years to come. Kids lose their back molars mostly between 11-12 years old. If that tooth is only 1 year away from falling out, I might consider having it extracted - which would let the permanent tooth jump right in when it's only a year away. However, if the dentist recommended a "root canal" - it is likely he or she gave that recommendation in your son's best interest of trying to save the baby tooth until it falls out much later. If a baby tooth is removed or lost years before the permanent tooth is meant to come in, the other teeth next to the space left by the lost tooth can close into that space, to the point where there is not enough room for the permanent tooth to grow in later. This can lead to BIG consequences in terms of the need for braces and how long it might take to fix with braces down the road. Saving the tooth is very often the best for your child when possible, and is also often the most cost effective option in the long run when considering braces complications down the road. Also, many dentists often use the term "root canal" fairly loosely when it comes to kids. I actually prefer not even using the term because of what comes to mind for most adults who have experienced this in an adult tooth - it's actually a TOTALLY DIFFERENT PROCEDURE. For adults, a root canal involves a VERY long procedure that is cleaning everything to the very end of the tips of the roots of that tooth. In baby teeth, the most common procedure that likely your dentist MEANT is called a Pulpotomy. This is less invasive than a full "root canal" and involves cleaning only the upper portion of the potentially contaminated nerve tissue in the "chamber" of the nerve, down to where the nerve enters the roots. Then once it is cleaned out (and it is indeed determined the tooth can be saved and is not infected) a medicated filling is placed in the chamber, and a crown fitted over the top to seal off the tooth and "rebuild" the structure of the tooth lost due to the decay. Now that crown is likely (usually over 90% success rate) of staying in your son's mouth until the permanent tooth comes in, and it falls out like any other baby tooth. So the term "root canal" can make it sound a little "over the top," when really when I perform this procedure for kids, it adds only 5-8 minutes to my procedure, and they don't feel anything different than if they had only needed a small filling for a small cavity.

A root canal can be done on a baby tooth in order to maintain the space until the permanent adult tooth is ready to erupt. If a baby tooth is extracted before the adult too erupts, the adjacent teeth can drift into the empty space and due to overcrowding, there may not be enough space for the permanent adult tooth.