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two patients Fillings, Crowns & Pulpotomy

Fillings, Crowns & Pulpotomy


Cavities come in all shapes and sizes, and the need for a filling will vary depending on your child’s age, the location of the cavity, and how much longer the tooth is going to be in the mouth.

Fillings restore a tooth that has been penetrated by infection, which has then caused a cavity. It’s important to address and stop the infection before it can cause further damage to the infected tooth or neighboring teeth.

Sometimes infections can grow to a more systemic problem: penetrating and harming the bone, gum tissue, or developing permanent teeth. The child may find it difficult to eat, concentrate, or do their schoolwork.

If your child is about to lose an infected tooth and it’s not causing them any pain or sensitivity, we may simply monitor a cavity instead of restoring it.


Crowns preserve the integrity of a tooth damaged by a cavity that’s too large to be remedied with a filling. When a cavity is on multiple surfaces of a tooth or encompasses a large portion of it, a filling has a very high chance of breaking. In that case, a crown is needed.

We primarily utilize stainless steel crowns because they are the most effective way to treat a large cavitation on a tooth, though we do offer both stainless steel and ceramic variations.

Most parents prefer stainless steel because ceramic crowns require a very dry, clean field, and are more challenging to place when working with a young child. Occasionally and in special circumstances, we do offer the more aesthetically pleasing ceramic crowns.

Keep in mind that baby teeth eventually fall out–usually by age 12–making the crown’s effectiveness our primary consideration.


The tooth is made up of three layers: the outer layer is the enamel, the middle layer is the dentin, and the innermost layer is the nerve or pulpal layer of the tooth where the nerves and the blood supply live.

As cavities grow, they can start to infiltrate the inner layers of the teeth. Depending on how deep the cavity has reached, the method necessary to treat the cavity may change. If the cavity is only in the outermost or dentin layer, a restoration filling is usually the treatment of choice. If the cavity is larger or covers more surface area, a crown may be needed. If the cavity penetrates the nerve layer, a pulpotomy, or sometimes a pulpectomy, is required to clean the nerve out and remove the bacteria.

A pulpotomy cleans out the chamber of the tooth and the nerve. A pulpectomy cleans the nerve in the chamber, as well as the nerve in the canals. Once the area is clean, we fill it with a medicament that preserves the tooth structure and kills any remaining bacteria. We then restore the tooth with a crown, or sometimes a filling.