Pulpectomy is a procedure to remove all the pulp from the crown and roots of a tooth. Pulp is the soft inner material that contains connective tissue, blood vessels, and nerves.
Pulpectomy is usually performed in children to save a severely infected baby (primary) tooth, and is sometimes called a “baby root canal.” In permanent teeth, pulpectomy is the first part of the root canal procedure.
A pulpectomy is complete removal of pulp from the crown and roots. The tooth is then filled with material that can be reabsorbed by the body. It’s usually performed on baby teeth.
A root canal starts with a pulpectomy, but the tooth gets a permanent filling or crown. It’s usually performed on permanent teeth.
Pulpectomy can be performed in one visit with these basic steps:
- X-rays are taken to look for signs of infection in surrounding areas and to get a look at the shape of the root canals.
- A local anesthetic is used to numb the area.
- A hole is drilled into the tooth.
- Small dental instruments are used to remove all the pulp.
- The tooth is cleaned, disinfected, and prepared for filling.
- The tooth is filled with resorbable material.
A root canal usually requires more than one visit to the dental office. Once the pulp is removed, as in a pulpectomy, the entire root canal system is cleaned, shaped, and filled and sealed. You’ll likely be sent home with a temporary crown, and then asked to return for permanent filling and a permanent crown.
Pulpectomy is used to save a baby tooth that has been severely damaged by decay or trauma. While baby teeth may not seem important enough for a dental procedure like this, there are valid reasons for pulpectomy.
The baby tooth is reserving a space for the permanent tooth. Premature loss of a baby tooth can cause problems like:
- difficulty chewing
- speech development issues
- having adjoining teeth move into the space, affecting the alignment of permanent teeth (this can lead to crooked, overcrowded teeth that are difficult to clean)
Material used to fill the tooth after a pulpectomy is designed to be reabsorbed by the body when the permanent tooth begins to erupt.
A pulpectomy is removal of all the pulp from the tooth’s upper chamber and the roots. A partial pulpectomy is when the dentist removes only the damaged portion of the pulp or all the pulp in the upper chamber of the tooth without touching the roots.
Once the damaged pulp is removed, the tooth is cleaned, disinfected, and filled.
A partial pulpectomy is also called pulpotomy, or pulp therapy. This procedure may an option when damage to the tooth is less severe.
Pulpectomy is performed when tooth enamel is damaged by decay. You may be able to prevent decay by practicing good oral care:
- Brush your teeth (or your child’s teeth) at least twice a day.
- Drink water with meals to wash away sugar and acids.
- Replace sugary drinks with water or milk.
- Have regular exams. Catching decay early may mean the difference between a standard filling and a pulpectomy.
Trauma to a tooth can also lead to decay. You can help lower the risk of injury during athletic activities by wearing a mouth guard. Be sure to visit the dentist following an injury to the mouth.
Pulpectomy may not be an option if the tooth is too severely damaged or if the roots themselves are damaged. That can happen when the tooth has cracked, especially below the gum line. If a child’s tooth is already loose, extraction may be a better choice than pulpectomy.
If a child’s baby tooth must be extracted, the dentist may want to put in a space maintainer until the permanent tooth comes in.
You or your child should be able to return to normal activities right away. Avoid eating until the numbness from the anesthetic wears off.
If the tooth was severely infected, the dentist may prescribe antibiotics. Be sure to take all of them, even if the tooth looks and feels better. The area around the tooth may be slightly swollen and sensitive for a few days, so you can take over-the-counter pain relievers.
Continue brushing and flossing as normal. Call the dentist if you have any of these symptoms:
- increasing pain
- pain that lasts more than a few days
- new inflammation or signs of infection around the tooth
- increasing sensitivity to heat and cold
- inability to chew on the tooth
Pulpectomy in a baby tooth should be sufficient to hold until the permanent tooth erupts. In a permanent tooth, regular dental checkups can catch any problems early. A permanent crown may eventually be necessary.
A pulpectomy can run from $80 to $300 or more. There’s a lot of variation in cost of this procedure due to factors such as:
- which tooth is involved
- how many imaging tests are taken
- whether you have dental insurance
- your insurance co-pays and deductibles
- if the procedure is performed by a dentist, pediatric dentist, or endodontist, and whether they’re in- or out-of-network
If you’re having a root canal with a permanent crown, the cost will be substantially higher.
Your dentist should be able to give you an estimate before the procedure. You can also contact your insurer prior to the procedure to see what portion may be covered.
Other than the time it takes to have the procedure, you most likely won’t have to take extra time off school or work.
Pulpectomy is a procedure to save a severely damaged tooth, usually a baby tooth.
It’s not always necessary or possible to save a baby tooth. But when the situation calls for it, pulpectomy can prevent problems with chewing, speech, and overcrowding that can occur when a baby tooth is lost too soon.
A dentist can determine the viability of the tooth and whether pulpectomy is the best option.