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If that happens you are looking at some kind of pulpal therapy like a Pulpotomy or removal of the tooth if it’s actually abscessed.
When a cavity gets really deep, close to the pulp of a tooth or even into the pulp, the pulpal tissue becomes irritated and inflamed.
The only time I have done them is for older teenagers with congenitally missing back teeth (with the baby tooth still there at that age) whose only cosmetic option is the porcelain fused to metal crown (those run around $800 or more each) and usually necessitates a pulpal treatment as well due to the small tooth size, and these crowns having a questionable prognosis in baby teeth.
It is probably more similar to Internal Resorption , which starts in the pulpal tissue rather than the coronal area, but I have to say I don't really know for sure what causes it. posted by Dr. Dean Brandon @ 4:33 PM