When deep tooth decay or trauma causes severe infection in a baby tooth's nerve (pulp), a pulpectomy offers the best chance to save the tooth and eliminate pain. This procedure—often called a "baby root canal"—involves removing all the infected nerve tissue from the tooth's crown and roots, then filling and sealing it to prevent further infection. At Dental Sedation Ottawa, we perform gentle, thorough pulpectomy procedures using comprehensive sedation options—from mild relaxation to complete sleep—ensuring your child receives this important treatment in complete comfort without fear or pain.
A pulpectomy is the complete removal of all pulp tissue (nerves and blood vessels) from both the crown (visible part) and roots of a baby tooth. Think of it as the pediatric equivalent of an adult root canal, though the procedure is actually simpler and faster because baby tooth roots are shorter and the filling material is designed to dissolve as the tooth naturally sheds.
The pulp is the soft tissue inside the tooth containing nerves, blood vessels, and connective tissue. When deep decay or trauma allows bacteria to invade this pulp, infection develops. The pulp becomes inflamed, dies, and eventually forms an abscess (pus-filled infection) at the root tips. This infection causes severe pain, swelling, and can damage the permanent tooth developing underneath.
Pulpectomy eliminates the infection by removing all the diseased pulp tissue, thoroughly cleaning and disinfecting the inside of the tooth, filling the empty root canals with a special medicinal paste that helps fight any remaining bacteria, and sealing the tooth to prevent new bacteria from entering.
After pulpectomy, the tooth no longer has living tissue inside it—it's essentially an empty, clean shell. But importantly, the tooth remains firmly attached to the jaw bone through the periodontal ligament (the tissue surrounding the root), so it continues functioning normally for chewing and maintains space for the permanent tooth underneath.
These terms sound similar but describe different procedures:
Removes only the infected pulp tissue from the tooth's crown (top part), leaving healthy pulp in the roots. Used when infection affects only the crown pulp and roots remain healthy. This is the more common procedure.
Removes ALL pulp tissue from both crown AND roots. Used when infection extends into the root canals or when root pulp is dead. This is more extensive but necessary for severe infections.
Your dentist determines which procedure is appropriate based on X-rays, symptoms, and clinical examination during treatment.
Questions about your options? We're here to help.
The words "root canal" often cause anxiety, even in adults. But for children with infected baby teeth, pulpectomy is often the only way to eliminate severe pain and save the tooth. At Dental Sedation Ottawa, we ensure this procedure is completely comfortable through comprehensive sedation options.
Mild relaxation for cooperative children ages 5+ with minimal anxiety. Your child stays awake, breathing through a comfortable nose mask, feeling calm and relaxed. Suitable for straightforward pulpectomy cases in children who tolerate dental procedures well.
Learn more about nitrous oxide →Medication taken before the appointment creates significant drowsiness and reduces anxiety. Excellent for moderately nervous children or when performing pulpectomy on multiple teeth. Your child remains responsive but deeply relaxed and typically won't remember the procedure.
Explore oral sedation →Deeper sedation administered through a tiny IV line provides continuous comfort throughout treatment, with constant monitoring. Ideal for high anxiety, younger children (ages 3-4), or when multiple pulpectomies plus other treatments need completion.
Discover IV sedation →Complete, peaceful sleep with zero awareness or memory. Administered by board-certified medical anesthesiologists (Dr. Hesham Talab, MD MSc PhD FRCPC FASE and Dr. Asad Mirghassemi, MD MSc FRCPC). Best for severe dental anxiety, special needs patients, very young children, or extensive treatment needs including multiple pulpectomies. Hospital-grade safety right in our clinic.
Learn about general anesthesia →With appropriate sedation, especially IV sedation or general anesthesia, we can perform pulpectomy on multiple teeth along with other needed treatments—crowns, fillings, extractions—all in a single comfortable appointment. One visit, one recovery period, significantly less overall stress for your family.
Questions about sedation options? We'll help you choose the right approach for your child.
Pulpectomy becomes necessary when infection or damage affects the entire pulp tissue throughout the tooth, including the root canals. This is more severe than the situations requiring pulpotomy.
When cavities penetrate deeply into the tooth and infection spreads into root canals, causing complete pulp death. The tooth may or may not hurt—sometimes severely infected teeth become quiet after the nerve dies completely.
Visible swelling, "pimple" on the gums (fistula draining pus), or evidence on X-ray of bone infection around root tips indicates pulp is completely dead and infected throughout.
Occasionally after pulpotomy, infection persists or returns because the root pulp was more damaged than initially thought. Pulpectomy becomes necessary to save the tooth.
Injuries that cause complete pulp death throughout the tooth—the tooth may darken (turn gray or brown) indicating dead pulp tissue.
Sometimes baby teeth are too damaged or infected to save, even with pulpectomy:
In these cases, extraction followed by a space maintainer is usually the better option. Your dentist thoroughly evaluates each situation before recommending pulpectomy.
Ready to learn more? Schedule a consultation to discuss your options.
Before the procedure, we examine your child's tooth clinically and take X-rays to assess the extent of infection, the shape and length of root canals, and whether the tooth is salvageable. We discuss sedation options based on your child's anxiety level and whether multiple teeth need treatment.
On treatment day, we begin by administering your chosen sedation option. Once your child is comfortable and relaxed (or peacefully asleep with general anesthesia), we ensure complete numbness of the treatment area. Throughout the procedure, our team continuously monitors your child for safety.
First, we place a rubber dam (a thin rubber sheet) over the tooth to isolate it from saliva and keep it dry during treatment. This also protects your child's mouth from the cleaning solutions we use.
The dentist opens the top of the tooth and removes all the infected pulp tissue from the crown portion. Using specialized tiny files, we carefully clean out each root canal, removing all pulp tissue and infected material. Baby molars typically have 3-4 root canals; front teeth have 1-2 canals. We measure the canal lengths precisely using X-rays and electronic devices to ensure we clean thoroughly without damaging developing permanent teeth underneath.
Throughout cleaning, we irrigate the canals repeatedly with antibacterial solutions to disinfect and flush out debris. Once all canals are thoroughly cleaned and shaped, we dry them and fill them with a special medicinal paste. This paste contains antibacterial medication (often zinc oxide eugenol or a similar material) that continues fighting infection and is designed to gradually dissolve as the baby tooth root naturally resorbs when it's time for the tooth to fall out.
We seal the top of the tooth with a filling material to prevent bacteria from re-entering, then place a crown (usually stainless steel for back teeth or esthetic crown for front teeth) over the tooth to protect it and restore full function.
Time Required: Pulpectomy on a single baby tooth takes 30-50 minutes depending on the number of root canals and their complexity. Multiple pulpectomies add approximately 25-35 minutes per additional tooth.
Ready to relieve your child's tooth pain?
Wait for numbness to wear off (2-4 hours) before eating. Start with soft foods, gradually returning to normal diet as comfort allows. Some mild discomfort and gum tenderness around the treated tooth is normal for 2-3 days—this is inflammation resolving, not ongoing infection.
Children's ibuprofen manages post-treatment discomfort effectively. Most children need pain medication only for 1-2 days. If significant pain persists beyond 3-4 days or worsens rather than improving, contact us.
If there was visible swelling before treatment (abscess), it takes 3-5 days to fully resolve even though the infection source has been removed. Sometimes antibiotics are prescribed for 7-10 days when infection was severe.
The treated tooth requires the same care as other teeth: brush twice daily with fluoride toothpaste, floss daily between all teeth, and maintain regular dental checkups every 6 months.
A successfully treated tooth should cause no pain and function normally for years. The tooth remains firmly in place, maintains space for the permanent tooth underneath, and the child forgets it ever had treatment.
The baby tooth will eventually fall out naturally—typically between ages 10-12 for back molars—with the crown attached. The medicinal paste in the root canals gradually dissolves as the root resorbs, allowing normal exfoliation. The permanent tooth underneath erupts normally, unaffected by the pulpectomy above it.
Occasionally (5-10% of cases), infection can return if bacteria re-enter the tooth through crown leakage or if some infected tissue remained. This shows up as new abscess formation, renewed pain, or changes visible on X-rays at follow-up appointments. Re-treatment or extraction becomes necessary in these cases.
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Pulpectomy success rates in baby teeth range 70-90% depending on the initial severity of infection, whether the tooth was abscessed, how thoroughly canals could be cleaned (some baby tooth roots have complex, curved canals), and how well the crown seals the tooth afterward.
When pulpectomy fails, extraction becomes necessary. However, even a tooth that functions successfully for 2-3 years before failing has provided valuable service by maintaining space, function, and appearance during critical developmental years.
Per tooth, depending on complexity
Protective crown after treatment
Tooth-colored option for front teeth
Baby molars with 3-4 canals cost more than front teeth with 1-2 canals. Total cost for pulpectomy plus crown ranges $500-850 per tooth for most cases. When multiple teeth require treatment under sedation, sedation fees are additional.
Most pediatric dental insurance plans cover pulpectomy at 50-80% as major restorative treatment when medically necessary to eliminate infection and save teeth. Crown coverage is typically similar (50-80%).
We provide direct billing to major insurance carriers and accept the Canadian Dental Care Plan (CDCP).
When you consider the alternatives—extracting infected baby teeth requiring space maintainers ($300-500 additional), loss of chewing function, speech problems from missing back teeth, and potential orthodontic complications—pulpectomy represents sound investment when successful outcomes are likely.
Our patients consistently rate us 5 stars for gentle, anxiety-free pediatric dental care. We're proud to have earned hundreds of positive reviews from families across Ottawa.
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View All Reviews on GoogleDentist Referrals Welcome: We collaborate with referring dentists throughout Ottawa and Eastern Ontario for pediatric sedation cases and complex pulp therapy procedures.
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