Inside every baby (deciduous) and permanent adult tooth is a central chamber containing connective tissue, a nerve supply, and blood vessels. These core tissues, known as the dental pulp, help the tooth grow and mature before it emerges into the mouth. Once a tooth erupts into place, the dental pulp provides nourishment, keeps the tooth vital, and signals the presence of problems.
Unfortunately, cavities and dental trauma can damage the vital tissues inside teeth. When the dental pulp of a baby tooth, also known as a primary or deciduous tooth, gets compromised by decay or injury, and there's no sign of infection, we frequently recommend "a baby root canal," known as a pulpotomy.
The purpose of root canal treatment on a "baby" tooth is to avoid further damage, prevent infection, and maintain the tooth until its permanent successor tooth comes into place. Because a prematurely lost baby tooth can result in space loss for its permanent successors and other consequences, often, the most therapeutic choice is to perform a pulpotomy and maintain the tooth in place.
While the phrase "baby root canal" can sound daunting, the procedure is as routine as getting a filling. A pulpotomy, when gently performed under local anesthesia, involves removing the exposed or affected tissues within the crown of the tooth (the visible portion of the tooth), then placing a special medication to disinfect the area and calm the remaining nerve tissue.
After the pulpotomy, a restoration is needed. Our pediatric dentist will recommend the most suitable restoration depending on the amount of tooth structure remaining and how much time is left before the baby tooth is expected to fall out. In many cases, a full-coverage pediatric dental crown offers maximum protection while preserving the space and restoring oral function.
Pulp therapy, often called a "baby root canal," is a pediatric dental procedure that treats the living tissues inside a primary (baby) tooth when those tissues are damaged by decay or injury. The goal is to remove or neutralize the diseased portion of the dental pulp while preserving the healthy tooth structure and its function. This treatment helps keep the tooth in the mouth until the permanent successor is ready to erupt.
Primary teeth play important roles in chewing, speech development, and maintaining space for adult teeth, so saving a decayed or injured baby tooth can prevent future orthodontic or developmental problems. Pulp therapy is a conservative alternative to extraction when the tooth can be predictably maintained. Your pediatric dentist evaluates the tooth carefully to determine whether pulp therapy is the best option.
A pulpotomy is recommended when decay or trauma reaches the crown portion of the tooth and affects the coronal pulp but the root pulp is still healthy and free of infection. If the pulp exposure is small and the infection has not spread into the root canals or surrounding bone, a pulpotomy can remove the affected coronal tissue and preserve the remaining healthy pulp. Radiographs and a clinical exam help the dentist determine the extent of pulp involvement and whether a pulpotomy is appropriate.
Other factors that influence the decision include the child’s medical history, behavior, age of the tooth, and how much natural tooth structure remains. When a tooth is close to exfoliation or the root is resorbing normally, the dentist may weigh the benefits and limitations of treatment differently. The objective is always to choose the least invasive treatment that reliably protects the child’s oral health and development.
A pulpotomy is typically performed under local anesthesia and sometimes with nitrous oxide or other behavior management techniques to keep the child calm and comfortable. The dentist removes the decayed tooth structure, accesses the coronal pulp chamber, and carefully removes the inflamed or exposed coronal pulp tissue before placing a medicament that disinfects and soothes the remaining pulp. The procedure is usually completed with a durable restoration to seal the tooth and protect it from further infection.
At Lighthouse Kids Dental we use gentle techniques and kid-friendly technology to make the visit as stress-free as possible for children and families. A stainless steel or pediatric crown is commonly used after pulpotomy to restore chewing function and preserve space until the permanent tooth erupts. The entire process is designed to be efficient while maintaining high standards for infection control and patient comfort.
After a pulpotomy, the treated tooth needs a permanent restoration that protects the remaining structure and prevents recontamination of the pulp space. In many situations a full-coverage pediatric crown, most often a stainless steel crown, is recommended because it provides long-lasting protection and preserves the tooth’s shape and function. For smaller defects where sufficient tooth structure remains, a tooth-colored composite restoration may be considered on a case-by-case basis.
The choice of restoration depends on how much natural tooth is left, the tooth’s location in the mouth, and the expected time before the primary tooth exfoliates. Your pediatric dentist will discuss the restoration options and explain why a particular type is best for your child. Proper restoration is a key part of the long-term success of pulp therapy.
A pulpotomy removes only the diseased or exposed coronal pulp and leaves the healthy tissue in the root canals intact, whereas a pulpectomy involves removing all pulp tissue from both the crown and the root canals. Pulpectomy is more similar to an adult root canal and is performed when the infection or inflammation extends into the root system and cannot be managed by coronal treatment alone. The choice between pulpotomy and pulpectomy depends on the extent of the disease, radiographic findings, and the tooth’s prognosis.
Pulpotomy is generally favored for primary teeth when the root pulp appears healthy and the prognosis for maintaining the tooth until exfoliation is good. A pulpectomy may be selected when root canal debridement and filling are necessary to eliminate infection. Your pediatric dentist will explain the clinical reasoning and expected outcomes for either procedure so you can make an informed decision for your child.
Pulp therapy is performed under local anesthesia, and many children experience little to no pain during the procedure thanks to modern anesthetic and calming techniques. Mild discomfort or soreness is common for a day or two after treatment as the tissues heal, and the dentist will provide guidance on appropriate over-the-counter pain relief and soothing measures. If nitrous oxide or conscious sedation is used, the child is closely monitored to ensure a safe and calm experience.
If discomfort increases, is severe, or is accompanied by swelling or fever, parents should contact the dental office promptly because these signs may indicate post-treatment infection or another complication. Routine post-operative checks help confirm healing and allow the dentist to address any concerns. Most children recover quickly and return to normal activities within a day or two.
After pulp therapy it’s important to protect the restored tooth from heavy or sticky foods for a short period to allow the restoration to set and the tissues to begin healing. Encourage the child to maintain normal oral hygiene practices—gentle brushing and flossing around the treated area—so the restoration and surrounding teeth remain healthy. Follow any specific instructions from your dentist about activity, diet, and medications during the first 24 to 72 hours.
Regular checkups and dental cleanings are essential to monitor the treated tooth until it naturally exfoliates and the permanent tooth erupts. If the child plays sports, a mouthguard may be recommended to prevent future dental injuries. Promptly report any signs of renewed pain, swelling, or visible damage to the restoration so the office can evaluate the tooth.
The goal of a pulpotomy is to maintain the primary tooth in a healthy, functional state until its permanent successor is ready to erupt, which can be months to several years depending on the child’s age. Success depends on the extent of the original disease, the quality of the restoration, and ongoing oral hygiene and dental care. Periodic radiographs and clinical exams are used to monitor healing and ensure the tooth remains free of infection.
Lighthouse Kids Dental schedules follow-up visits to check the treated tooth and to confirm that natural root resorption and exfoliation are proceeding normally. If any signs of recurrent infection or failure appear, the dentist will review alternative treatment options and next steps. Consistent preventive care helps maximize the lifespan of the treated primary tooth.
Like any dental procedure, pulp therapy carries some risks, including incomplete healing, recurring infection, or failure of the restoration, which could require additional treatment or extraction. Rarely, a treated tooth can develop an abscess or persistent symptoms that necessitate re-treatment or alternative care. Your pediatric dentist will explain these possibilities and how they are monitored and managed.
Early diagnosis of problems during follow-up exams typically allows for timely intervention and better outcomes. The benefits of saving a primary tooth—preserving space, function, and speech development—are carefully weighed against the risks before recommending pulp therapy. Clear communication with your dental team helps ensure that potential complications are addressed promptly.
When a primary tooth is too damaged, the child’s medical condition contraindicates endodontic treatment, or the tooth’s prognosis is poor, extraction may be the recommended alternative to pulp therapy. Extraction removes the source of infection and pain but also creates a need to manage the resulting space so that permanent teeth erupt in the correct position. Depending on the child’s age and the tooth involved, a space maintainer may be recommended to preserve arch length until the permanent tooth arrives.
The decision between pulp therapy and extraction is individualized and based on clinical findings, radiographs, and the child’s overall dental development. Your pediatric dentist will discuss the short- and long-term implications of each option and help you choose the approach that best supports your child’s oral health and growth. Prompt evaluation after trauma or deep decay ensures the most appropriate, tooth-preserving choices are considered whenever possible.
