Does My Son Really Need a Pulpotomy?

My pediatric dentist wants to schedule my son, who is only 6 years old, for a pulpotomy procedure. Is this really necessary for a baby tooth that is going to fall out anyway?


Dear Susanna,

I am glad you wrote. I never want parents to allow their child to have a procedure they don’t understand. For those who may not know, a pulpotomy is a child’s version of a root canal treatment. It is only useful if the tooth is a molar.

While most baby teeth can come out early with no serious repercussions, back molars need to stay in place until your son is around 12 years old. Otherwise, the adjacent teeth will begin to shift or tip into the empty place. Then, when his adult molars erupt, you are looking at a lot of crowding and expensive orthodontics. Every parent wants to avoid braces if at all possible.

So, if it is a back tooth, you will either want to get the pulpotomy or extract the tooth and then have a space maintainer placed to keep the area open for the adult teeth.

If it is not a back tooth, then you will not need the pulpotomy. However, it is also important that you deal with the tooth. I am assuming that he suggested this treatment because the tooth has an infection. These are considered dental emergencies so you will not want to leave it.

Infections spread. If you think about how close your child’s jaw is to his heart, lungs, and brains, you can see how these things can turn life-threatening quickly.

If your pediatric dentist was not willing to explain why he or she thought you needed one, I feel strongly you would be better served with a different dentist for your precious son. Parents are the ones responsibile for their children and they deserve to have all the information in order to make the best possible decisions for their children.

If you can’t find a great pediatric dentist in your area, there are plenty of general dentists who love to treat entire families, including their children. Each of them has done a pediatric rotation and will be qualified to provide their dental care.

This blog is brought to you by Phoenix Dentist Dr. Hillary Peck.

Dentist Wants to Replace all My Fillings

I have quite a few fillings in my mouth and my dentist says they all need to be replaced. I’m having a hard time fathoming that they all need to be replaced. Is this really necessary?


Dear Mandy,

A lot of my response will depend on a few factors. Are they silver amalgam fillings or white composite fillings? If they are amalgam fillings, is he planning on replacing them with more of the silver fillings? I would not let him do that.

As fillings age, they start to deteriorate. If you have amalgam fillings, it is possible they have started to leak. This is dangerous for both you and your teeth. These also tend to crack or erode faster as well. The main ingredient in amalgam fillings is mercury, so you don’t want to let this deteriorate in your mouth.

Additionally, eroding or leaky fillings will allow bacteria to seep in. This leads to tooth decay. These usually go unnoticed until it develops into an infection. Then you have a dental emergency on your hands and will need a root canal treatment.

If your dentist is wanting to replace them with composite fillings, I would feel better about that. These are better for your teeth and completely mercury-free. They also bond directly to your teeth, which will strenghten them.

Make Sure You See a Mercury-Free Dentist

If you are getting your dental fillings replaced, you definitely need to do it with a mercury-free dentist. They know how to do a sanitary amalgam removal. Mercury is a known toxin, so you do not want to accidentally swallow any mercury or inhale any mercury vapors.

Mercury-free dentists have the proper equipment and understand the porcedure to keep you from mercury exposure.

This blog is brought to you by Phoenix Dentist Dr. Hillary Peck. We offer pediatric services.