Impact of Pulpectomy vs. Tooth Extraction on Children’s Oral Health

UK: Researchers from various esteemed institutions worldwide, including the Department of Paediatric Dentistry at the International University of Catalunya, Barcelona, Spain, the Department of Epidemiology & Public Health at University College London, London, UK, and others, have conducted a randomised clinical trial titled “Impact of pulpectomy versus tooth extraction in children’s oral health-related quality of life.” 

The study aimed to assess the effects of two common treatment options for primary molars with pulp necrosis in young children – pulpectomy and tooth extraction – on the children’s oral health-related quality of life (OHRQoL).

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Crucial Examination of Paediatric Dental Care

The research involved a total of 100 children between the ages of 3 to 5 years, all of whom had at least one necrotic primary molar. These children were selected and randomly assigned to either the pulpectomy or tooth extraction treatment groups.

The study’s primary focus was on evaluating the impact of these two treatment options on children’s oral health-related quality of life (OHRQoL). To measure this, the Brazilian version of the early childhood oral health impact scale (B-ECOHIS) was employed. Parent proxy reports of the children’s B-ECOHIS scores were collected at baseline and after 4, 8, and 12 months.

Results Shed Light on the Superior Treatment

The study’s findings revealed compelling results. At the outset, the mean B-ECOHIS scores were 17.7 (SD 6.5) for the pulpectomy group and 18.8 (SD 7.7) for the extraction group. 

After 12 months, these scores significantly improved to 3.0 (SD 4.0) for the pulpectomy group and 7.9 (SD 7.7) for the extraction group. Both treatments demonstrated an enhancement in OHRQoL; however, the tooth extraction group displayed higher scores in total B-ECOHIS and most domains, which indicated a lower OHRQoL.

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Addressing Dental Anxiety

Additionally, the study delved into the psychological aspect of these treatments. Higher anxiety levels were reported for dental extraction when compared to pulpectomy, with an odds ratio (OR) of 2.52 and a significance level of p = 0.008.

The study’s conclusion is of paramount importance for pediatric dentists and parents alike. It suggests that pulpectomy is the preferable treatment option for necrotic primary molars in children, as it leads to improved OHRQoL scores after 12 months compared to tooth extraction. This research has the potential to influence clinical practice and enhance the well-being of young patients undergoing dental procedures.

This study signifies a significant step forward in the field of pediatric dentistry, emphasizing the importance of considering the holistic impact of dental treatments on a child’s overall well-being and quality of life. Further research and clinical application of these findings are expected to follow.

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