On this page · 6 sections
01Why it matters
The pulp is the soft tissue inside a tooth that holds nerves and blood vessels. When a cavity grows deep, bacteria can reach the pulp and make it inflamed. If only the top part is affected, a pulpotomy can treat the problem and keep the tooth.
Saving a baby tooth matters. Baby teeth help children chew, speak clearly, and smile. They also hold space for the adult teeth growing underneath. Losing one too early can let nearby teeth drift and crowd the adult teeth.
Text version of this infographic
Step 1: the tooth is numbed and the decay is removed. Step 2: the inflamed pulp in the crown of the tooth is removed, and the healthy pulp in the roots is left in place. Step 3: the space is filled with a medicated filling, and the tooth is usually covered with a crown.
02Signs and causes
The most common cause is deep tooth decay. An injury that cracks or breaks a tooth can also expose the pulp. Signs your child may need care include:
- A toothache, especially with cold or sweet foods and drinks.
- A dark spot or hole in a tooth.
- Pain while chewing.
- A chipped or broken tooth after a fall.
Get urgent care: a fever, or swelling that spreads across the face, toward the eye, or down the neck, needs immediate attention. Call 911 or go to the nearest emergency room.
03What happens
The dentist examines the tooth and takes X-rays to see how deep the decay goes. The area is numbed first so your child stays comfortable. The dentist removes the decay and the inflamed pulp in the crown of the tooth. The healthy pulp in the roots is left in place.
Next, the dentist places a medicine in the tooth to help the remaining pulp heal. The tooth is sealed with a filling. Most baby teeth then get a crown, a cap that covers and protects the tooth. A pulpotomy is sometimes used on a young adult tooth whose roots are still growing.
A pulpotomy is different from a full root canal. A root canal removes all the pulp, including the pulp inside the roots. At a family practice, this care is part of kids' dentistry. [OFFICE TO CONFIRM: whether pulpotomies are done in the office]
04Cost factors
What treatment costs depends on:
- Which tooth is treated and how much decay there is.
- Whether the tooth needs a crown afterward, and the type of crown.
- Whether X-rays or other care are needed at the same visit.
- Your dental insurance plan. Call the office to check what your plan covers.
- The option to use CareCredit for care provided at the office.
05Caring for your child's teeth
- Have your child avoid chewing on the treated side until the numbness wears off.
- Brush twice a day with fluoride toothpaste, and help young children brush.
- Limit sugary snacks and drinks, especially between meals.
- Keep regular checkups so the dentist can check the treated tooth and catch new cavities early.
Worried about a deep cavity in your child's tooth? See our kids' dentistry page.
06Questions people ask
Is a pulpotomy the same as a root canal?
No, though people sometimes call it a baby root canal. A pulpotomy removes only the pulp in the top part of the tooth and leaves the healthy root pulp. A root canal removes all the pulp, including the pulp in the roots.
Will my child feel pain during a pulpotomy?
The tooth is numbed before treatment, so most children feel pressure rather than pain. The area may feel sore for a short time afterward. Ask the dentist which over-the-counter pain medicine and dose are right for your child.
Why fix a baby tooth that will fall out anyway?
Baby teeth hold space for adult teeth and help children chew and speak. Some baby back teeth stay in place for years. Losing one early can let other teeth shift and cause crowding later.
Does the tooth need a crown after a pulpotomy?
Usually, yes. A baby tooth with deep decay is often weak, so a crown helps protect it from breaking. The dentist will explain which type of crown fits your child's tooth.
Dr. Sadek is the family dentist at Americana Family Dental on Americana Blvd in Orlando. He reviews the health information on this site. Review date: [date pending review]