Pulpotomy & Stainless Steel Crowns Consent

Informed Consent: Pulpotomy and Stainless Steel Crowns

Tooth# ________________

Please review this information carefully and note any questions you may have.  There might not be a quiz, but we’re going to ask you to sign a computerized version of this consent acknowledging that you’ve read and understood and have had a chance to ask any questions you have about the following information.

Why Crown A Baby Tooth?

When a tooth has decayed to the point of needing a really big filling, those big fillings can crack and break and fall out.  Nearly 80% of fillings placed in baby teeth need to be replaced over the lifetime of the baby tooth.  As much as we love seeing you and your child here at the dentist’s office, we’d rather fix this tooth once and not have to keep putting your child through fixing a big filling that’s just going to break again.

Also, if a pulpotomy or “nerve treatment” (we’ll explain that in a minute) has been done, the tooth structure that remains will be very brittle and subject to breakage. 

A stainless steel crown is a way to protect that tooth and make sure it stays in your child’s mouth until the adult tooth is ready to come in.

A crowned baby tooth will fall out naturally when the permanent tooth erupts.

It’s Just A Baby Tooth… Why Not Just Pull It?

There’s a natural order to the way baby teeth come and go and how adult teeth replace them.  In addition to being there for your child when your child needs to chew, those baby teeth are keeping space open for the long-awaited adult teeth.  Pulling a baby tooth today will not make the adult teeth arrive any faster. 

Even teeth are subject to diva-like behavior, we suppose.

If we were to just pull your child’s tooth today, and the adult tooth is still years away from growing in, we’d need to place a space maintainer, to keep that spot open for when the adult tooth eventually moves in.  If we skip that space maintainer step, other teeth can crowd that spot, causing all sorts of troubles down the road. 

Pulpotomy: Treating a Tooth’s Last Nerve

A baby tooth’s nerve is found in a space inside the tooth called the pulp chamber.  When tooth decay reaches the pulp chamber, bacteria infect the nerve.  If left untreated, the bacteria and infection spread to other tissues and cause a painful abscess.

To save the tooth, we remove the infected nerve tissue from the pulp chamber.  Then we fill the chamber with a special medication to stop the pain and protect the tooth.  The final step is to place a stainless steel crown on top of the tooth to keep other bacteria out and to keep the tooth from breaking.

The clinical success rate for pulpotomies on baby teeth range from 75% to 80%. The success of a pulpotomy depends on the severity of the infection and your child’s ability to fight the infection. It’s possible for a tooth that’s had a pulpotomy to abscess later, with no pain, usually. An untreated tooth will abscess and need to be extracted and a space maintainer placed. 

It is strongly recommended that your child receive regular six-month checkups so that we can keep the teeth under close observation.