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Duke Oral Health

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DSPD Safety Protocol




If the nerve is infected, baby teeth respond well to the removal of a diseased part of the dental pulp while leaving the healthy portion intact.  The cavity is removed from the tooth in addition to the portion of the pulp that has been infected by the bacterial growth from the cavity.  A disinfectant is placed on top of the remaining pulp, the tooth is sealed and a crown (silver cap) is placed over the tooth.  This allows the tooth to stay vital (alive) within the mouth.


What are the advantages and disadvantages of pulpotomies?

The obvious benefit is that the tooth is maintained in service and holds the space for the developing permanent tooth below it.  The disadvantages are the teeth that have had nerve treatments are likely to require a crown (silver cap) to be placed on the tooth to provide adequate strength.  Occasionally, the bacterium invades the nerve completely and the pulpotomy fails and the tooth must be removed, but the risk is low.


Are there alternatives?

Alternatives include removal of the tooth (with the diseased nerve) and the placement of a space maintainer, which will hold space for the permanent tooth to erupt between ages 10 – 12 years old.


What is the result of no treatment?

Usually the patient will experience continued and increased pain and infection and also the risk of damage to the underlying permanent tooth below the infectious (baby) tooth. Ignored nerve infection will usually result in an abscess and require removal

of the tooth.