A pulpotomy is treatment for tooth decay that affects pulp inside the crown of your tooth. A dentist or endodontist removes the damaged pulp, replacing it with medicated material. The procedure leaves your tooth root in place. The procedure is most often done to treat tooth decay in primary (baby) teeth.

A pulpotomy is a dental procedure to remove unhealthy tooth pulp. It’s a common treatment for inflammation or infection in your child’s tooth that a deep cavity causes. The procedure removes unhealthy pulp in the top part of the tooth. It leaves the baby tooth and tooth root in place to save a spot for your child’s permanent tooth. Most children have this procedure because they have a cavity in a molar (back tooth).

You may have this procedure if a cavity or an injury like a cracked tooth lets bacteria invade the pulp. Your dentist may recommend this procedure instead of a root canal.

A dentist, pediatric dentist or endodontist may do this procedure.

Most adults don’t need to do anything to get ready for this procedure. But you should let your dentist or endodontist know if you have dental anxiety. They’ll suggest steps you can take to manage your anxiety. They may recommend you have special anesthesia, so you’re completely relaxed during the procedure.

Kids may be a different story. If this is the first time your child needs a procedure, their pediatric dentist may suggest things you can do to help your child feel less anxious.

The first step is medication so you or your child doesn’t have pain during the procedure. If you’re having a pulpotomy, your dentist will give you a shot near the infected tooth and the nearby gum. The shot will numb the area. Your child’s dentist may give your child a liquid sedation before they give them anesthesia. Next, your dentist will:

  • Place a piece of thin, flexible rubber over your tooth and nearby gums. This is a dental dam. It keeps your tooth dry during treatment.
  • Drill a small hole in the top of your tooth so they can get to the pulp inside the tooth.
  • Remove unhealthy pulp.
  • Put medicated filling in your tooth. This protects the tooth root and reduces the chance you’ll get another infection.
  • Seal the top of your tooth with dental cement.

The procedure takes about 30 to 45 minutes. The final step is placing a dental crown on your tooth. Your dentist may do that right away. But they may wait a few weeks to be sure the pulpotomy took care of the infection.

What are the potential benefits or risks of a pulpotomy?

This procedure helps with pain that inflammation may cause. It also keeps infection from spreading while saving the tooth root, so the baby tooth remains in place. A pulpotomy is very safe with few risks. But sometimes, the procedure doesn’t remove all unhealthy tooth pulp. In that case, you or your child may need to have another pulpotomy, a pulpectomy or a tooth extraction.

That depends on the medication you or your child receives to manage pain during the procedure. For example, if your dentist uses a numbing medication, it may take a few hours before the medication wears off. But it may take 24 hours for sedation medication to wear off. In that case, you or your child should plan on taking it easy for the rest of the day.

The dental filling, or crown, is expected to last until a permanent tooth replaces the baby tooth with the filling. Most children lose their back baby teeth when they’re 9 to 12 years old. But your child’s situation may be different, so ask their dentist what you can expect.

Contact your dentist if you or your child has:

  • Severe pain that doesn’t go away with medication.
  • A swollen face or jaw.
  • Fever, chills or other infection symptoms.
  • American Academy of American Association of Endodontics. Management of Endodontic Emergencies: Pulpotomy versus Pulpectomy. (https://www.aae.org/specialty/newsletter/management-of-endodontic-emergencies-pulpotomy-versus-pulpectomy/) Fall 2017. Accessed 8/11/2025.
  • Igna A. Vital Pulp Therapy in Primary Dentition: Pulpotomy-A 100-Year Challenge (https://pubmed.ncbi.nlm.nih.gov/34682106/)Children (Basel). 2021 Sep 24;8(10):841. Accessed 8/11/2025.
  • Solomon RV, Faizuddin U, Karunakar P, et al. Coronal Pulpotomy Technique Analysis as an Alternative to Pulpectomy for Preserving the Tooth Vitality, in the Context of Tissue Regeneration: A Correlated Clinical Study across 4 Adult Permanent Molars (https://pmc.ncbi.nlm.nih.gov/articles/PMC4449924/?_ga=2.129236876.149381977.1584290088-1459216834.1584041425)Case Rep Dent. 2015;2015:916060. Accessed 8/11/2025.
  • Tewari N, Goel S, Mathur VP, et al. Success of medicaments and techniques for pulpotomy of primary teeth: An overview of systematic reviews (https://pubmed.ncbi.nlm.nih.gov/35271753/)Int J Paediatr Dent. 2022 Nov;32(6):828-842. Accessed 8/11/2025.
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