Dental caries, the most common chronic childhood disease, creates unique problems in the primary dentition.
Untreated caries causes children to lose time from school and parents to lose time from work, and children with toothaches are at a greater risk of having lower grades.
The goal of pulp therapy in primary teeth is to maintain the primary tooth until it exfoliates in order to maintain the integrity of the dental arch.
Primary teeth also guide the eruption of the permanent tooth. Pulp therapy for a primary tooth helps avoid an abscess, and maintains the tooth for function, aesthetics, speech, mastication, and overall health.
There are now many options to treat primary teeth with deep caries approximating the pulp. These include: indirect pulp treatment (IPT), direct pulp cap (DPC), and pulpotomy. IPT is a procedure in which deep caries close to the pulp is left in place and covered with a biocompatible material to avoid a pulp exposure in asymptomatic teeth or a pulp with reversible pulpitis.
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The DPC is indicated when there has been a pinpoint mechanical or traumatic exposure to a normal pulp and caries was not the cause of the pulp exposure.
A pulpotomy is a procedure in which the coronal pulp is removed, and the radicular pulp is treated after caries removal has created a pulp exposure in a healthy pulp or a pulp with reversible inflammation.
° Vital Pulp Therapy in Primary Teeth: An Update - Lance Kisby, DMD