Pulpotomy for baby teeth: when a deep cavity reaches the pulp
A pulpotomy is a pediatric dental procedure used for selected baby teeth when decay has reached the pulp in the crown of the tooth but the tooth can still be predictably preserved. Parents sometimes hear it described as a "baby root canal," but it is not the same procedure as root canal treatment on an adult tooth.
Educational content only. Your child's diagnosis and treatment plan require an in-person dental evaluation.
Reviewed by Dr. Gabriela Asensi, DMD, MPH · Last updated September 22, 2026
SmileWorks provides both pulpotomy and pulpectomy for baby teeth at our Tallahassee office. A pulpotomy removes the diseased pulp in the crown of the tooth and treats the remaining root tissue; a pulpectomy treats the whole pulp when the roots are involved. Either is usually followed by a crown so the weakened tooth can last until it falls out naturally.
What the procedure actually does
Inside each tooth is pulp tissue containing nerves and blood vessels. During a pulpotomy, the diseased or inflamed pulp tissue in the crown portion of the tooth is removed. The remaining tissue in the roots is evaluated and treated so the tooth can remain functional.
Pulpotomy or pulpectomy?
The difference is how far the pulp problem extends. A pulpotomy is chosen when the pulp in the roots is still healthy enough to keep. A pulpectomy removes and treats the pulp tissue throughout the crown and the root canals of the baby tooth, using a filling material designed to resorb as the baby tooth's roots naturally dissolve. SmileWorks provides both; the dentist decides based on symptoms, X-rays, and what is found during treatment.
When pulp therapy may be considered
A pediatric dentist considers symptoms, X-rays, restorability, whether infection has spread around the roots, and how long the tooth is expected to remain in the mouth.
If a tooth has signs that make pulp therapy unlikely to succeed, another option, including extraction with a space maintainer when needed, may be more appropriate.
Why a crown is often placed afterward
A baby molar that needs a pulpotomy usually has significant loss of tooth structure. A full-coverage crown can protect the remaining tooth better than a large filling in many cases.
Depending on tooth position, esthetic priorities, and the treatment plan, the dentist may discuss stainless steel or tooth-colored zirconia crown options.
Will the tooth still fall out normally?
The purpose of successful pulp therapy is to preserve the baby tooth until it is naturally ready to exfoliate. The permanent tooth continues developing underneath.
What symptoms should parents report?
Spontaneous pain, swelling, a gum bump near the tooth, fever, facial swelling, or pain that repeatedly wakes a child at night can indicate a more advanced problem and should be evaluated promptly. We hold same-day emergency time at our Tallahassee office for exactly this.
Questions families ask
Is a pulpotomy the same as a root canal?
No. A pulpotomy removes and treats pulp tissue in the crown portion of a selected primary tooth. Root canal therapy removes pulp tissue throughout the canal system.
What is the difference between a pulpotomy and a pulpectomy?
A pulpotomy treats only the pulp in the crown of the tooth and keeps healthy root pulp. A pulpectomy treats the pulp all the way through the roots of the baby tooth. Both are offered at SmileWorks.
Does every deep cavity need a pulpotomy?
No. The need depends on how close decay is to the pulp, symptoms, clinical findings, and whether the pulp has been exposed or inflamed.
Why put a crown on a baby tooth after pulpotomy?
The tooth is often structurally weakened by the original decay and treatment. Full coverage can provide more durable protection until the tooth naturally falls out.
What if the tooth is already infected?
If infection extends beyond what can be treated predictably with pulp therapy, extraction or another treatment may be recommended.
Where this fits in the bigger picture
Restorative pediatric dentistry
Fillings, SDF, crowns, pulp therapy, and extractions, matched to the tooth and the child.
Restorative pediatric dentistry →Dental crowns for kids
Why a weakened baby tooth may need a crown, and how the material is chosen.
Dental crowns for kids →Stainless steel crowns
The durable workhorse for baby molars, and what parents notice.
Stainless steel crowns →Zirconia (white) crowns
NuSmile tooth-colored ceramic crowns: when they fit and how they differ from stainless steel.
Zirconia (white) crowns →Cavity treatment for kids
What happens next after "your child has a cavity," stage by stage.
Cavity treatment for kids →Pediatric sedation dentistry
The full continuum, from nitrous oxide to in-office IV sedation with a pediatric anesthesiologist, and when hospital care fits.
Pediatric sedation dentistry →Deep decay does not always mean losing the tooth. The exam tells us whether it can be predictably saved.
Call to schedule; if your child is in pain, tell us and we will find same-day time.
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