Updated on April 25, 2024
6 min read

What Is a Pulpectomy?

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What is a Pulpectomy?

A pulpectomy is a dental procedure that involves removing the pulp from a tooth’s crown and roots. It can help prevent tooth removal in cases of severe decay, trauma, or infection.

The pulp is the soft inner layer of a tooth. It contains the tooth’s nerves, blood vessels, and connective tissue. The pulp chamber can become infected if the tooth enamel and dentin are damaged. 

During a pulpectomy, a dentist removes the infected or diseased pulp and then fills the crown and roots with a therapeutic material. 

Pulpectomy vs. Pulpotomy vs. Root Canal

Pulpectomies, pulpotomies, and root canals are similar but different procedures. They’re all safe, effective procedures that aim to save a severely damaged tooth. 

Here’s how they compare:

Pulpectomy vs. Pulpotomy

Pulpectomies and pulpotomies treat infection, decay, or trauma that has reached the pulp of a tooth. However, the procedures and problems they treat are different.

Procedure TypePulpectomyPulpotomy
Procedure Steps:Removes all the pulp from the crown to the rootsRemoves only the coronal pulp (the pulp in the main chamber of the tooth above the gum line)
What it Treats:Both primary and permanent teeth with dead or infected pulp and abscessesCan only be completed on permanent or primary teeth that are still alive with no abscesses

Pulpotomies are usually done in baby teeth with pulp damage. They can also be performed on adult teeth that are severely damaged or have cavities that reach the pulp.

Pulpectomy vs. Root Canal

Root canal treatment begins with a pulpectomy and then takes it a step further. The tooth will need a permanent filling or crown to prevent reinfection. It’s usually performed on a permanent tooth. 

A root canal is a more extensive dental treatment that may require more than one visit to the dentist. They may apply a temporary crown after the first visit while the permanent one is being made. 

Procedure TypePulpectomyRoot Canal
Procedure StepsRemoves diseased pulp from a tooth, then cleans and disinfects the inner chamber before packing it with inert material the body reabsorbsBegins with a pulpectomy, then the dentist covers the tooth with a permanent crown or filling
What it TreatsAdult and baby teethTypically only adult teeth
Number of VisitsOne Usually more than one

What is a Partial Pulpectomy?

Partial pulpectomy and pulp therapy are alternative names for a pulpotomy. It refers to a procedure in which the dentist only removes the damaged portion of the tooth’s pulp or the pulp in the upper chamber of the tooth. They don’t touch the tooth root.

When is a Pulpectomy Necessary?

A dentist might recommend a pulpectomy to treat the following:

  • A baby tooth with dead pulp
  • An adult tooth with infected pulp or an abscess
  • Damaged or decaying teeth with infected dental pulp

Pulpectomy on a Primary Tooth

Dentists often perform pulpectomies on children to treat primary teeth with dead (necrotic) pulp. For this reason, a pulpectomy is sometimes called a baby root canal in pediatric dentistry.

A pulpectomy can help save a baby tooth that reserves space for a permanent tooth. Otherwise, premature loss of a baby tooth can lead to:

  • Problems with chewing
  • Speech development issues
  • Adjoining teeth shifting into the space

Pulpectomies on Permanent Teeth

A dentist may perform a pulpectomy on an adult tooth as the first step in a root canal procedure. 

After removing the pulp and cleaning the inner chamber of the tooth, the dentist will finish the root canal with a permanent crown or filling.

Pulpectomy Procedure Steps

A pulpotomy will only take under an hour. In some complicated cases, however, the procedure will take longer. This is what happens during the procedure:

  1. The dentist will take X-rays of the tooth to look for any infection in the surrounding areas and determine the shape of the tooth’s entire root canal system.
  2. Before the procedure, the dentist will administer a local anesthetic to numb the tooth and avoid discomfort during treatment. 
  3. Some people request sedation like nitrous oxide or general anesthesia because they have dental anxiety. 
  4. The dentist will isolate the target tooth, usually using a rubber dam or intraoral suction device.
  5. They’ll remove the decayed part of the tooth with dental instruments.
  6. They’ll then use a spoon excavator and other dental instruments to remove the infected pulp from the tooth’s crown and root canal.
  7. After removing the pulp, the dentist will disinfect the tooth.
  8. They’ll then fill the tooth with a biocompatible material.

Is a Pulpectomy Painful?

While a pulpectomy may be painful for some patients, local anesthesia can effectively numb the area so that you do not feel pain during the procedure. Your dentist may also prescribe pain medication and antibiotics after the procedure if your tooth is severely infected, helping manage any post-procedure discomfort.

    What to Expect After Pulpectomy Treatment

    After a pulpectomy procedure, there may be increased sensitivity and discomfort around the treated tooth. Your dentist may recommend pain medication. 

    You can resume chewing, eating, and everyday activities immediately after the numbness from the local anesthesia wears off. Avoid eating while your mouth is numb.

    If your tooth is severely infected, your dentist may prescribe antibiotics. They’ll also likely want to monitor the treated tooth with follow-up X-rays every 6 months. The tooth will be more susceptible to fractures and discoloration.

    How Much Does a Pulpectomy Cost?

    Generally, a pulpectomy will cost about $80 to $300 without insurance. Like every dental treatment, the cost of a pulpectomy will vary depending on a multitude of factors:

    • Whether or not you have dental insurance to help cover the cost (and your insurance plan details)
    • Who is performing the pulpectomy procedure (a dentist, an endodontist, a pediatric dentist, etc.)
    • How much imaging you need to have before the pulpectomy
    • Which tooth you need to be treated

    How to Avoid Getting a Pulpectomy

    You can try to prevent the need for a pulpectomy by practicing good oral hygiene and taking the following steps:

    • Brush your teeth at least twice a day and floss before going to bed
    • Brush and floss your child’s teeth if they’re too young to do it themselves
    • Replace sugary drinks with water 
    • Visit your dentist for routine exams and professional teeth cleanings


    A pulpectomy procedure is done to save a severely damaged tooth from extraction. It’s usually done on a baby tooth with dead pulp from an injury, infection, or decay. It can also be done on a permanent tooth as part of a root canal.

    Pulpectomies involve the complete removal of all dental pulp. Pulpotomies remove only the pulp above the gum line. Your dentist will examine your teeth to determine the best procedure for your needs. 

    Last updated on April 25, 2024
    6 Sources Cited
    Last updated on April 25, 2024
    All NewMouth content is medically reviewed and fact-checked by a licensed dentist or orthodontist to ensure the information is factual, current, and relevant.

    We have strict sourcing guidelines and only cite from current scientific research, such as scholarly articles, dentistry textbooks, government agencies, and medical journals. This also includes information provided by the American Dental Association (ADA), the American Association of Orthodontics (AAO), and the American Academy of Pediatrics (AAP).
    1. Xie, et al. “Survival Analysis of Pulpectomy in Primary Molars Performed Under Dental General Anaesthesia: A Two-Year Retrospective Study.” BMC Oral Health, 2022.
    2. Ahmed, HMA. “Pulpectomy Procedures in Primary Molar Teeth.” European Journal of General Dentistry, 2014.
    3. Songvejkasem, et al. “Survival Rate and Associated Factors Affecting Pulpectomy Treatment Outcome in Primary Teeth.” Clinical and Experimental Dental Research, 2021.
    4. Dou, et al. “A Retrospective Study on the Long-Term Outcomes of Puplectomy and Influencing Factors in Primary Teeth.” Journal of Dental Sciences, 2022.
    5. Tirupathi, et al. “Clinical Efficacy of Single-Visit Pulpectomy Over Multiple-Visit Pulpectomy in Primary Teeth: A Systematic Review.” International Journal of Clinical Pediatric Dentistry, 2019.
    6. Abanto, et al. “Impact of Pulpectomy Versus Tooth Extraction in Children’s Oral Health-Related Quality of Life: A Randomized Clinical Trial.” Community Dentistry and Oral Epidemiology, 2023.
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