What is a Pulpotomy Procedure?

A pulpotomy is the surgical removal of an inflamed pulp chamber due to the invasion of some ugly bacteria. It’s a complicated word for a very common procedure in pediatric dentistry. The success rate is high and it is also something which can be done in conjunction with other procedures if needed.


As a parent or caregiver it is important to know that inflammations in the pulp chamber do occur in young children affecting their baby teeth. Your child may appear grumpy or if they are old enough, complain their tooth hurts. It is necessary to address this inflammation to prevent infection and to save the tooth itself.

How Does A Pulp Tissue Develop Inflammation?

When a cavity gets extremely deep, it can get too close to the pulp of the tooth or even into the pulp. The tissue then gets irritated and swollen, resulting in a feeling similar to that of a toothache. If this inflammation goes on without any treatment, an abscess can form.

A Pulpotomy In Baby Molars

In baby molars the purpose of a pulpotomy is to try to save and restore the tooth. The decay is removed in the top part of the pulp chamber. The root canals are not removed. Pulpotomies may buy some time, but they cannot save an already abscessed tooth. However, it can save a badly decayed baby tooth.

The Pulpotomy Procedure

The procedure includes removing the nerve in the crown (the part of the tooth nearest the gum line) and a filling material is placed in the nerve chamber. This helps keep the nerve tissue intact. Following the nerve treatment, the tooth needs to be restored. Most often a crown is used for final restoration

Benefits Of A Pulpotomy

  • It may prevent unnecessary loss of teeth due to a possible infection.
  • It may give a developing permanent tooth a chance to fully develop

The success of the procedure depends on the extent of the decay. Sometimes the inflammations occur due to the natural bacteria in the mouth. Staying in tuned with your child’s dental habits and health can help you in identifying a problem early.


A pulpotomy is when the inflamed pulp chamber, usually on a baby molar, is removed, the area is sterilized, and the chamber is sealed. It is sometimes called a baby tooth root canal, but it’s not really a root canal and it can be done is some cases in permanent teeth. It is a very common procedure in children and has a reasonably good prognosis of success. It’s also fairly easy to do in conjunction with associated procedures.


When a cavity gets really deep, close to the pulp of a tooth or even into the pulp, the pulpal tissue becomes irritated and inflamed. This is usually the “tooth ache” you feel. If the inflammation and infection continues without treatment, the tooth will likely eventually abscess. In baby molars, a pulpotomy is used in the process of trying to save and restore the tooth. First, the decay is removed, and then the pulp chamber (the top part, not the root canals) is removed usually with a high-speed bur or spoon excavator. A small cotton ball damp with formocresol is placed to “mummify” the pulp stumps and to sterilize the area. After a couple of minutes, the cotton ball is removed and the opening is sealed usually with a Zinc Oxide and Eugenol material like IRM. IRM is a putty like material that hardens up after a few minutes. After a pulpotomy on a baby molar, it is usually necessary to place a stainless steel crown to restore the tooth. The most common method to treat pulpotomized teeth is formocresol. Other methods include Ferric Oxide, MTA, electrosurgery and even lasers.


Pulpotomies have reasonably good prognosis. It may buy some time, but cannot save an already abscessed tooth. It is often surprising to me how a seemingly small area of decay can be deep enough to reach the pulp. This is often due to the varied antomy of baby teeth and the rapid progression of decay. Although a very reliable procedure, rarely, a tooth with a pulpotomy will have complications and need to be extracted. This is usually due to the remaining pulp tissue in the root canals giving some kind of trouble.


Bottom line: A pulpotomy is a really good and reliable way to save a badly decayed baby tooth.