Updated on February 9, 2024
4 min read

Pulpotomy Procedure

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What is a Pulpotomy Procedure?

A pulpotomy (literally “pulp cutting”) is a common procedure in pediatric dentistry. It’s often used to save baby teeth that are severely decayed or cracked.

The pulp is the “living” part of a tooth, containing many nerves and blood vessels. If a tooth has a cavity deep enough to reach the pulp, it can lead to significant pain and sensitivity.

The goal of a pulpotomy is to remove the inflamed pulp while keeping the tooth “alive.” This means only the coronal pulp (in the tooth’s crown) is removed. The roots of the tooth aren’t affected.

Once the inflamed pulp is gone, the tooth is sealed, and a crown is placed on top of the tooth.

When is a Pulpotomy Necessary?

A pulpotomy may be recommended for the following:

  • Tooth decay, dental trauma, or a filling that exposes the pulp chamber
  • Large amalgam or composite resin restorations that fail
  • Cracked tooth syndrome

These conditions can cause significant pain and tooth sensitivity. They may lead to irreversible pulpitis and eventually an abscess if left untreated.

Your dentist can determine whether you or your child will need a pulpotomy using X-rays and evaluating your symptoms.

Who is a Good Candidate?

You may be a good candidate for a pulpotomy if your tooth is significantly damaged or decayed but still has some remaining healthy pulp.

A pulpotomy is not a good treatment option if there isn’t any viable pulp left or the surrounding tissues are affected. The infected tooth will require a pulpectomy (root canal) or dental extraction to avoid further pain and complications.

People with chronic inflammatory conditions or cancer may not be good candidates for a pulpotomy. This is because their immune systems are weakened, and the procedure could lead to an infection.  

Pulpotomy vs. Pulpectomy

Pulpotomies and pulpectomies both aim to save the structure of the tooth. The key difference is that a pulpotomy preserves some of the tooth pulp.

This is why a pulpotomy is also known as “vital pulp therapy.” It restores a tooth to its healthy state.

A pulpectomy, on the other hand, is part of root canal therapy. It’s performed for teeth that are considered necrotic or dead. The pulp is removed from the canal(s) before the tooth is sealed and restored.

Both procedures allow a tooth to maintain its function and esthetics, eliminating the need for tooth extraction.

Pulpotomy Procedure Steps

A pulpotomy can be performed by a general dentist, endodontist, or pediatric dentist.

The dental professional performing the pulpotomy treatment may depend on your child’s age and the location of the tooth being treated.

The pulpotomy technique involves the following steps:

  1. Dental X-ray — An X-ray of the tooth is necessary to evaluate the pulp. It will also help rule out the need for a complete pulpectomy or extraction.
  2. Local anesthetic — Your dentist will numb the area to avoid discomfort during the procedure.
  3. Isolation — Many dentists use an isolation device to prevent blood or saliva from contaminating the tooth. This may include an intraoral suction device or rubber dam to separate the tooth from the rest of the mouth.
  4. Removal of decay — The decayed area of the tooth will be removed until the pulp chamber is exposed. The dentist will then amputate the coronal pulp.
  5. Sealing the tooth — Once the infected pulp has been scooped out and a medicament has been applied, the tooth will be sealed with mineral trioxide aggregate (MTA) or calcium hydroxide.
  6. Full coverage — A final restoration, such as a stainless steel crown, will likely be needed to protect and support the tooth, especially if it is weakened or prone to fracture.

Pulpotomy Recovery Timeline and Tips

You can expect to experience temporary bleeding, swelling, and numbness for a few hours following the procedure. Many dentists recommend over-the-counter pain relievers like ibuprofen (Advil) or acetaminophen (Tylenol).

It’s also recommended to avoid eating until you’re no longer numb to avoid biting your lip or cheek.

If you experience symptoms for more than 48 hours after a pulpotomy, you should follow up with your dentist or endodontist. 

How Much Does a Pulpotomy Cost?

Most dental insurance policies offer full or partial coverage for pulpotomies. This will lower your out-of-pocket cost.

Without insurance, you can expect a pulpotomy to cost between $80 and $350. X-rays, fillings or crowns, and other additional procedures may make the total cost higher.

Kids and Adults

Although a pulpotomy is sometimes called a “baby root canal,” it doesn’t affect the tooth roots. A pulpotomy leaves the roots of a tooth healthy.

It’s usually a priority to preserve the pulp tissue in the roots of baby teeth. The baby teeth are placeholders for the permanent teeth to emerge in the future.

In adults, all permanent teeth have already come in, so a complete root canal treatment may not cause any problems.

However, permanent teeth with enough healthy pulp can have pulpotomies performed, keeping the root pulp intact.


A pulpotomy is a partial removal of the tooth pulp, usually performed on primary teeth. It’s important to keep these teeth, since they are placeholders for the permanent teeth.

This procedure may be necessary if tooth decay or trauma has led to exposure or infection of the pulp. However, some healthy pulp must still be present in the tooth. Otherwise, a root canal or extraction may be required.

Last updated on February 9, 2024
7 Sources Cited
Last updated on February 9, 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. Baik, S.A., et al. “Pulpotomy vs pulpectomy techniques, indications and complications.” International Journal of Community Medicine and Public Health, 2018.
  2. Tawil, Peter Z., et al. “Mineral trioxide aggregate (MTA): its history, composition, and clinical applications.” Compendium of Continuing Education in Dentistry, 2015.
  3. Gadallah, Lamia, et al. “Pulpotomy versus pulpectomy in the treatment of vital pulp exposure in primary incisors. A systematic review and meta-analysis.” F1000Research, 2018.
  4. Li, Yuanyuan, et al. “Pulpotomy for carious pulp exposures in permanent teeth: A systematic review and meta-analysis.” Journal of Dentistry, 2019.
  5. Lin, Po-Yen, et al. “Primary molar pulpotomy: a systematic review and network meta-analysis.” Journal of Dentistry, 2014.
  6. Barngkgei, Imad Hassan, et al. “Pulpotomy of symptomatic permanent teeth with carious exposure using mineral trioxide aggregate.” Iranian Endodontic Journal, 2018.
  7. Allison, J.R., et al. “The painful tooth: mechanisms, presentation and differential diagnosis of odontogenic pain.” Oral Surgery, 2020.
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