Pulp therapy in children
Diagnosis, root status, infection and the child's overall plan guide choice. A well-sealed restoration and follow-up remain essential.
Understand
Pulp therapy options depend on a reliable pulpal diagnosis and the status of the root and supporting tissues. A sound coronal seal is essential.
Assess
Take pain history and radiographs where indicated; look for spontaneous pain, swelling, sinus, pathological mobility or furcation radiolucency.
Apply
Select a vital or non-vital approach only when indicated and feasible. Explain uncertainty and follow-up; do not place a vital pulp dressing in a tooth showing clear infection.
Key distinctions
In a primary molar, a furcation lesion may be a more prominent radiographic sign of infection than an apical lesion. The distinction between a vital pulp treatment and treatment for a non-vital infected tooth depends on symptoms and clinical findings. A well-sealed final restoration is integral; a technically successful pulpotomy beneath a leaking crown is vulnerable.
Think through a case
A primary molar has no spontaneous pain and a restorable crown after caries removal. The choice of pulpal therapy depends on findings, root status and sealability.
The distinction to remember
Do not base treatment on the child's ability to describe pain alone; examination and imaging may reveal infection.
Test your recall
Would a furcation radiolucency change the plan?
Show answer
Yes; it suggests infection and affects suitability for vital pulp treatment.