Pulpotomies

What is a pulpotomy?

A pulpotomy is a treatment for a baby tooth where we gently remove the sick or irritated “nerve” in the top part of the tooth, while keeping the roots healthy and in place. Many parents hear this called a “baby root canal,” but it is a simpler, quicker version of what is done on adult teeth. We do this most often on baby molars (back teeth) when a cavity has gone deep enough to reach the nerve.clevelandclinic+7

Baby teeth are important place‑holders that help guide the grown‑up teeth into the correct position, so saving them when we can is usually the best choice.willowtreedentistry+3

Why Might My Child Need One?

We recommend a pulpotomy when a cavity or injury has reached the nerve in the tooth, but the roots are still healthy enough to keep the tooth. This helps:alamoheightspediatricdentistry+5

• Stop pain and sensitivity from a deep cavity or infection.sweettoothkidsdentist+5
• Prevent the infection from spreading and causing an abscess (swelling or pus).healthline+3
• Keep the baby tooth in place so your child can chew comfortably and hold space for the adult tooth underneath.jeffreymfaldutodmd+4 

If we did nothing, the tooth would likely continue to hurt, the infection could worsen, and the tooth might need to be removed early.mykidshappyteeth+4

Signs Your Child Might Need a Pulpotomy

Every child is different, but common warning signs parents might notice include:

• Ongoing toothache that doesn’t go away or keeps coming back.kidsdentalpals+5
• Pain when chewing or biting on that tooth.canberrahealthservices.act.gov+3
• Sensitivity to hot or cold foods and drinks.putneydentalcare+4
• A darkened, gray, or discolored baby tooth.sweettoothkidsdentist+2
• Swelling or redness in the gums near the tooth, or part of the face looking puffy.kidsdentalpals+3
• A visible large cavity or hole in the tooth.mykidshappyteeth+3 

Any of these signs means your child should be seen soon so we can take an X-ray, test the tooth, and recommend the best treatment.canberrahealthservices.act.gov+4 

How We Do a Pulpotomy (step‑by‑step, kid‑friendly)

We focus on keeping children comfortable and relaxed. Here is what usually happens during a pulpotomy on a baby tooth:

1. Numbing and comfort

We first make the tooth “go to sleep” with a local anesthetic so your child does not feel pain during the procedure. Depending on your child’s age and anxiety level, we may also use laughing gas or other safe sedation options to help them feel calm.kidsdentaltipsyoutubeclevelandclinic+3

2. Keeping the tooth dry and clean

We place a small rubber sheet called a “raincoat” (rubber dam) around the tooth to keep it dry and protect the rest of the mouth.youtubeclevelandclinic+2

3. Cleaning out the cavity

We gently remove the decayed part of the tooth and open the top of the tooth so we can see the nerve area inside. The damaged portion of the nerve in the crown of the tooth is removed, but the healthy nerve tissue in the roots is left in place.clevelandclinic+2youtubeputneydentalcare+1 

4. Medicine inside the tooth

We place a special medicated material over the remaining healthy nerve to soothe it, protect it, and help it stay healthy. This lowers the chance of future infection and keeps the tooth comfortable.kidsdentaltips+2youtubeputneydentalcare+2

5. Sealing and covering the tooth

After the medicine, we fill the top of the tooth and usually place a small stainless‑steel crown (a silver “helmet” for the tooth) to protect it from new cavities and cracks. This crown is very strong and is designed to last until the baby tooth falls out naturally.willowtreedentistry+6

Most children do very well afterward. Mild soreness is possible once the numbness wears off, but it usually improves quickly and is easily managed with over‑the‑counter pain medicine if needed.healthline+5