Pulpotomy is a dental procedure used to save decayed, infected teeth. If you or your child has a severe cavity, plus infection in the tooth’s pulp (pulpitis), your dentist may recommend pulpotomy to you.

This procedure is also recommended when repair of a deep cavity exposes the pulp underneath, leaving it vulnerable to bacterial infection.

With pulpotomy, pulp is scooped out and removed from within the tooth’s crown. The crown of the tooth is the part surrounded by enamel that you see above the gum line.

Pulp is the innermost part of the tooth. It’s comprised of:

  • blood vessels
  • connective tissue
  • nerves

A deeply decayed tooth can cause inflammation, irritation, or infection to occur within a tooth’s pulp. This can threaten the life of the tooth, plus affect the gums, and surrounding areas of the mouth.

If your tooth has a deep infection that extends into or near the root, a root canal may be recommended instead of pulpotomy. Root canal procedures remove all of a tooth’s pulp, plus the roots.

Because pulpotomy leaves the roots of a tooth intact and able to grow, it’s used primarily in children with baby (primary) teeth, which have an immature root formation.

Baby teeth help maintain spacing for the permanent teeth that will follow, so leaving them intact is often a priority.

Severalstudies have shown that this procedure can also be used effectively in adults and in children with secondary teeth, provided that enough healthy pulp exists within the tooth to keep it healthy and vital.

Your dentist will take an X-ray of your teeth to determine your need for a pulpotomy or any procedure.

General dentists usually perform pulpotomies or root canals. If a specialist is needed, your dentist will likely refer you to an endodontist.

Your dentist may prescribe antibiotics for you to start taking 3 or 4 days before the procedure and up until several days afterward.

Anesthesia

Small children may require general anesthesia or light sedation for this procedure.

Nitrous oxide, which is commonly known as “laughing gas,” is frequently used during the procedure for light sedation and to help make the procedure more comfortable.

If general anesthesia or light sedation is required, the dentist or endodontist will provide you with written instructions about how to prepare.

These instructions will include restrictions on when to stop eating and drinking. Usually, this timeframe is 6 hours before general anesthesia and 2 to 3 hours before light sedation.

It’s important to note that if general anesthesia is used, an oral surgeon could perform the procedure.

Getting a child ready

Preparing for any type of dental procedure can be anxiety-producing, especially for children.

If your child needs a pulpotomy, they may already have a toothache. Let your child know that this procedure will make that pain go away.

Also let them know that the procedure itself will not hurt and only lasts for half an hour to 45 minutes.

Getting yourself ready

If you’re the one getting ready for a dental procedure, you may be nervous as well.

Though research indicates that pulpotomies can be successfully performed on adults, your dentist will likely recommend a root canal since you have a more mature tooth structure.

Whichever procedure your dentist recommends, keep in mind that it’s being done so that your tooth can be salvaged.

What to expect

  • Before the procedure begins, your dentist will numb the area with a local anesthetic. This injection typically doesn’t hurt, although you may feel a slight, fleeting pinch.
  • If anesthesia is being used, it’ll be administered to your child in the dentist’s chair, either through a nose piece for light sedation or via an injection in the arm for general anesthesia.
  • The decayed area of the tooth will be removed with a drill.
  • Your dentist will drill through the tooth’s enamel and dentin layers until the pulp is exposed.
  • The infected material within the tooth’s crown will be scooped out and removed.
  • The empty space where the pulp was will be filled with dental cement to seal it closed.
  • A stainless steel crown will be cemented onto the existing tooth, which becomes its new outer surface.
  • Unlike pulpotomy, pulpectomy is done to remove all the pulp, plus the roots of an infected tooth. This procedure is required when the infection extends below the tooth’s crown.
  • Pulpectomy is sometimes referred to as a baby root canal. In primary teeth, it’s done to preserve the tooth. In secondary teeth, it’s usually done as the first step in a root canal.

Your tooth, gums, and the surrounding area of your mouth will be sufficiently numbed throughout the procedure so that you don’t feel any pain.

Afterward, children who received anesthesia or light sedation will be monitored for 30 minutes to 1 hour before they can leave the dentist’s office.

During this time, most children bounce back quickly. In some instances, sleepiness, vomiting, or nausea may occur.

You may also notice slight bleeding for several hours.

Avoid eating or drinking while your mouth is numb to avoid accidentally biting your inner cheek.

Once you’re able to eat, stick to soft food, such as soup or scrambled eggs, and avoid anything crunchy.

Some pain or discomfort is likely to occur once the anesthesia wears off. Over-the-counter pain medication, such as acetaminophen (Tylenol), is usually sufficient for alleviating pain.

Do not eat or drink on the side of the mouth where the procedure took place until complete healing has occurred.

The cost of this procedure will vary based on several factors. These include whether anesthesia is required and your geographic area.

If you have dental insurance, talk to your insurer about costs you can expect to incur out of pocket, as well as a list of providers you can pick from to ensure coverage.

If you don’t have dental insurance, you can expect to pay anywhere from $80 to $300 for just the procedure.

The cost of a crown may increase that price to $750 to $1,000 or more.

Your out-of-pocket costs may be higher if general anesthesia is required.

If your pain is severe, or you continue to feel pain after several days have passed, call your dentist. Intense or persistent pain may indicate that additional treatment is needed.

A certain amount of swelling is to be expected right after the procedure.

However, if you experience new swelling, redness, or pain during the days, weeks, or months that follow a pulpotomy, call your dentist. These symptoms may indicate the tooth is infected.

Pulpotomy is a dental procedure done to save a severely decayed tooth.

It’s most commonly done on children with baby teeth, but it may also be used for adults and older children who already have their permanent teeth.

This procedure is used to remove infected pulp from under the tooth’s crown. It’s less invasive than a root canal.

You should experience no pain during a pulpotomy and only minor pain afterward.

If only a pulpotomy is being done on a permanent adult tooth, the tooth should be watched and monitored.