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Causes and Symptoms

The center of the tooth is made up of pulp tissue, a collection of blood vessels that deliver essential nutrients to the tooth to grow. The pulp tissue in the tooth can be damaged by a variety of factors:
  • Deep tooth decay
  • Cracks and chips in the tooth (fracturing)
  • Trauma
  • Repeated dental procedures
If pulp tissue becomes inflamed, it can lead to pulp death (necrosis), which can lead to infection of the tissue that surrounds the tooth. Symptoms of pulp inflammation include:
  • Visible injuries to the tooth
  • Sensitivity to temperature
  • Spontaneous pain in the tooth
Symptoms of infection include:
  • Swelling of tissue around the tooth
  • Dull, aching pains usually associated with biting or chewing

Treatments

Root Canal

During a root canal, a patient is given a local anesthetic and the damaged and infected pulp tissue is removed from the tooth. Then the the root canal is thoroughly cleaned and sealed. The procedure may take several visits depending on the treatment needed.

Pediatric Pulp Therapies

Apexogenesis

Apexogenesis is a pediatric dental procedure used on children whose pulp tissue has been damaged in the crown of a tooth, but before it has progressed to a root canal. Damaged and infected material is removed from the crown, but the healthy tissue in the root canal is left in place. The remaining healthy tissue is covered in a material that encourages the healthy tissue to grow and to continue to develop. The tip of the root, known as the apex, will continue to develop as the child ages. If the pulp tissue heals, then no further treatments will be necessary.

Apexification

Apexification is a pediatric dental procedure used on children when pulp tissue damage or infection has spread throughour the root canal system, but when the root canal system is not yet fully developed. The endodontist will clean out the root canal and place a meterial into the canal that will encourage the growth of hard tissue near the apex, or root tip. This hardened tissue creates a barrier for the root canal filling. The root canal walls will not continue to develop after this procedure, which will make the tooth suscpetible to fracturing.