Inside every primary (baby) tooth and many developing permanent teeth sits a soft core of connective tissue, nerves, and blood vessels known as the dental pulp. That tissue helps a tooth form and mature, supplies nourishment, and signals when something is wrong. When decay or an injury reaches the pulp of a baby tooth but the infection has not extended into the root, a pulpotomy can remove the diseased portion, preserve the remaining healthy tissue, and allow the tooth to stay in place until its permanent successor arrives.
A pulpotomy is primarily used in pediatric dentistry to treat a primary tooth that has a damaged or exposed coronal pulp but no clear signs of root infection. Typical causes that lead to consideration of this treatment include extensive cavities that approach the pulp, a recent traumatic injury that exposes the pulp, or deep decay that threatens the integrity of the tooth. The main goal is to eliminate the inflamed tissue that causes pain while keeping the rest of the tooth vital and functional.
Not every tooth with pulp involvement is a candidate. Before performing a pulpotomy, the dentist evaluates the tooth with a clinical exam and appropriate X-rays to make sure there is no abscess, root pathology, or advanced internal infection. In primary teeth, preserving structure until normal exfoliation is often preferable to extraction because premature tooth loss can lead to space loss and future orthodontic issues.
For developing permanent teeth, different vital pulp therapies may be indicated depending on the extent of injury and how mature the root is. Your child’s dentist will recommend the approach that best supports long-term tooth health while minimizing future complications. When a pulpotomy is chosen, it reflects a conservative intent: to remove only the diseased coronal pulp and maintain what remains of the tooth.
A pulpotomy is usually performed in a single appointment and is tailored to the child’s comfort and cooperation. The area is numbed with a topical and local anesthetic so the child feels minimal discomfort. The dentist then isolates the tooth and removes decayed tissue to reach the pulp chamber. Only the infected or inflamed coronal pulp—inside the visible crown portion of the tooth—is removed.
Once the affected tissue is removed, the clinician gently disinfects the chamber and places a medicament designed to calm the remaining nerve tissue and reduce bacterial contamination. The medicated dressing promotes healing in the radicular pulp (the tissue in the roots) and helps preserve tooth vitality. The procedure focuses on precision and gentle technique to avoid disturbing healthy structures.
After the pulpal treatment, the tooth is sealed with a durable restoration to prevent reinfection. Because primary molars must withstand chewing forces and protect the treated area until exfoliation, a full-coverage restoration is often the most reliable option. The entire process is done with the child’s comfort and safety as the highest priority.
Following a pulpotomy, the success of the treatment depends heavily on an effective restoration that seals the tooth and restores function. In many cases, a stainless steel crown (SSC) is the preferred choice for primary molars because it fully covers and protects the remaining tooth structure. Stainless steel crowns are durable, resist leakage, and help prevent future fractures in teeth weakened by decay or treatment.
The selection of a restoration considers several factors: how much tooth structure remains, the child’s age and expected time until exfoliation, and the location of the tooth. When only a small portion of the crown remains, or when the tooth needs to withstand heavy chewing, an SSC offers the best combination of longevity and protection. For anterior teeth or less compromised restorations, a tooth-colored material might be used when clinically appropriate.
Your dentist will explain why a particular restoration is recommended for your child and how it contributes to the long-term stability of the treated tooth. The objective is always to provide a restoration that minimizes future problems and preserves space for the permanent tooth to come in naturally.
Recovery from a pulpotomy is typically straightforward. Most children experience only minor soreness for a day or two after the procedure, which can be managed with recommended over-the-counter pain relief and simple comfort measures. Eating soft foods for a short period and avoiding very hard or sticky items helps protect the restoration while the tooth settles.
Good oral hygiene remains essential: routine brushing and flossing around the treated area will help prevent new decay. The dentist will schedule follow-up visits to monitor healing and ensure the tooth remains symptom-free. Regular dental checkups and radiographs allow the clinician to confirm that the roots remain healthy and that the tooth is functioning as intended.
If parents notice persistent pain, swelling, a bad taste or odor, or any signs that the treated tooth is not improving, they should contact the dental office promptly. Early assessment can determine whether additional treatment is needed to address complications and protect adjacent teeth and developing permanent successors.
The primary benefits of a successful pulpotomy are pain relief, preservation of the baby tooth, and maintenance of space for the permanent tooth. By keeping the primary tooth in place until its natural exfoliation, a pulpotomy helps protect proper alignment and supports normal chewing, speech development, and facial growth. In many cases, treated teeth remain symptom-free until they are gently lost at the appropriate time.
That said, pulpotomy is a conservative treatment rather than a permanent cure in every circumstance. Some treated teeth can require additional attention if infection develops later or if the restoration becomes compromised. Routine monitoring by the child’s dentist ensures any changes are caught early and managed with minimal disruption.
When performed as part of comprehensive pediatric dental care, a pulpotomy is an effective, tooth-preserving option that balances immediate relief with long-term oral health goals. The office of Shuli Blobstein, DMD, PLLC emphasizes careful diagnosis, gentle technique, and appropriate restoration to give each child the best possible outcome.
In summary, a pulpotomy is a focused, conservative treatment designed to remove diseased coronal pulp from a baby tooth while preserving the healthy root tissue beneath. It relieves pain, prevents premature tooth loss, and helps maintain normal dental development. If you’d like to learn more about pulpotomy, whether it may be the right option for your child, or what to expect before and after treatment, please contact us for more information.
