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Pulpotomy In Primary Teeth

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Medically Reviewed By Colgate Global Scientific Communications

We know that as a parent or caregiver of a young child, your priority is their health and safety. From routine medical and dental checkups to feeding them a well-rounded diet, you work hard to keep their smile healthy. But did you know that it's common for cavities to develop in a child's baby (or primary) teeth? The National Institute of Dental and Craniofacial Research reports that 42 percent of children ages 2 to 11 have had cavities in their baby teeth!

When decay is severe, it may result in what's known as pulpitis (painful inflammation of the pulp). Your child's dental professional can perform a pulpotomy procedure to remove the part of the pulp that has been infected by tooth decay. But what exactly is a pulpotomy, and how will you know if it's needed? Let's go over everything you'll need to know about this procedure and possible treatments for pulpitis. This way, both you and your child will feel prepared!

Symptoms and Diagnosis

Below the protective layers of enamel and dentin, your child's tooth has an inner layer of pulp that houses the tooth's nerves and blood vessels. When a cavity reaches this layer of the tooth, the pulp can become inflamed and very painful. A few symptoms of reversible and irreversible pulpitis:

  • Reversible pulpitis is a tooth that is painful to the touch. But the pain can subside, and over-the-counter pain medication alleviates it.
  • Irreversible pulpitis includes an unprovoked toothache, excessive mobility of the tooth, and inflamed soft tissue that isn't a result of gingivitis or periodontal disease.

An X-ray is pivotal for discovering the extent of the damage to your child's tooth. A dental professional must determine if, upon removing the decay, the tooth can be repaired. Unfortunately, extraction of the tooth may be necessary if it's not repairable. Depending on your child's age and where this particular tooth is located in their mouth, temporary replacement or space management decisions may be necessary for their permanent tooth to erupt properly.

Your child's dentist's next decision is to determine if their tooth's nerve is still alive and just inflamed from the decay. If the nerve is dead, it may require a root canal (pulpectomy) or extraction instead of a pulpotomy. In some cases, your child's baby tooth may be ready to "shed" or "exfoliate" anyway, as an adult tooth is about to erupt. If this is the case, it makes sense to extract it.


There are two approaches to treating an inflamed nerve from decay. The first is an indirect pulp cap where the pulp chamber or the upper part of the nerve is not removed. Instead, your child's dental professional will put medication on top of it. This reduces inflammation, prevents the decay's progression, and promotes healing.

The second approach is the pulpotomy (removing the pulp chamber above the area where the nerve extends into the tooth's roots). Medication is also applied to the chamber's base to maintain the nerve's vitality in the root and prevent any further infection. The tooth is then restored to its original shape. A primary molar will usually have a stainless steel crown placed, and a front tooth may receive a form of composite restoration.

To prepare your child for a pulpotomy, let them know that it's not a long procedure, and they should not feel any pain. They will have anesthesia to numb the area of the mouth where the cavity is already most likely causing pain. Once the procedure is complete, the aftercare is like most standard dental procedures. Ensure your child doesn't eat or drink within the timeframe your dental professional instructs, watch for bleeding and buy over-the-counter pain medications if your child feels discomfort once the numbness wears off.


The best preventive tool for fighting cavities, tooth decay, and an inflamed and painful pulp? A stellar oral care routine! For children, fluoride toothpaste and brushing with a soft-bristled toothbrush are necessary for keeping their primary teeth healthy. Additionally, within six months of their first tooth erupting, you should schedule regular appointments with their dental professional for checkups and professional dental cleanings.

While you do everything you can to make sure your child has a healthy smile, there's still a chance they will develop a cavity. A pulpotomy in primary teeth is never anticipated, but a vigorous oral care routine and regular dental checkups are crucial to keeping all the layers of your child's teeth healthy. If your child needs a pulpotomy, let them know that it will ease their tooth pain and keep their tooth intact.

Oral Care Center articles are reviewed by an oral health medical professional. This information is for educational purposes only. This content is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your dentist, physician or other qualified healthcare provider. 

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