When decay reaches the nerve of your child's baby tooth, a pulpotomy can eliminate the infection, stop the pain, and save the tooth until it naturally falls out. This common pediatric procedure—sometimes called a "baby root canal"—removes only the infected pulp tissue from the tooth's crown while leaving healthy pulp in the roots intact. At Dental Sedation Ottawa, we perform gentle, effective pulpotomy procedures using comprehensive sedation options—from mild relaxation to complete sleep—ensuring your child receives this important treatment in complete comfort without fear or anxiety.
A pulpotomy is the partial removal of infected or inflamed pulp tissue from a baby tooth. Specifically, we remove the diseased pulp from the crown (the visible part of the tooth above the gums) while leaving the healthy pulp in the roots undisturbed. Think of it as a focused cleaning of the infected area while preserving the tooth's vitality in the root canals.
The pulp is the soft tissue inside every tooth containing nerves, blood vessels, and connective tissue. When deep cavities allow bacteria to reach this pulp, infection and inflammation develop. The pulp in the tooth's crown becomes painful and diseased, but often the pulp deeper in the roots remains healthy and capable of maintaining the tooth's vitality.
Pulpotomy takes advantage of this situation by removing only the damaged crown pulp, then covering the healthy root pulp with medicinal materials that promote healing, fight bacteria, and protect against further infection. This allows the tooth to remain alive (vital) and continue developing and functioning normally until it's time for it to naturally fall out and be replaced by the permanent tooth underneath.
These similar-sounding procedures differ in scope:
Removes infected pulp from the crown only, leaving healthy root pulp. Used when infection is limited to the crown portion. Most common pediatric pulp therapy procedure.
Removes ALL pulp tissue from both crown and roots. Used when infection extends throughout the entire tooth. More extensive treatment for severe cases.
Your dentist determines which procedure is needed based on symptoms, X-ray findings, and clinical assessment during treatment. Most cases benefit from the less invasive pulpotomy approach.
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The idea of nerve treatment can sound frightening, but pulpotomy is actually one of the most effective ways to eliminate severe tooth pain and save baby teeth. At Dental Sedation Ottawa, we ensure this procedure is completely comfortable through our comprehensive sedation options.
Mild relaxation for cooperative children ages 4+ with minimal anxiety. Your child stays awake, breathing through a comfortable nose mask, and feels calm and sometimes giggly. Suitable for straightforward single pulpotomy in children who tolerate dental visits well.
Learn more about nitrous oxide →Medication taken before the appointment creates drowsiness and significantly reduces anxiety. Excellent for moderately nervous children or when performing pulpotomy 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 team monitoring. Ideal for high anxiety, younger children (ages 2-4), or when multiple pulpotomies 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. Hospital-grade safety right in our clinic.
Learn about general anesthesia →With appropriate sedation, especially IV sedation or general anesthesia, we can perform pulpotomy on multiple teeth along with other needed treatments—crowns, fillings, extractions, cleanings—all in a single comfortable appointment. One visit, one recovery period, dramatically less overall stress for your family.
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Pulpotomy becomes necessary when tooth decay extends deep enough to reach and infect the pulp (nerve), but the infection hasn't spread throughout the entire root system yet. The crown pulp is damaged or dying, but root pulp remains healthy enough to preserve.
Tooth hurts without any obvious trigger—pain comes on by itself, especially at night. This indicates pulp inflammation or infection.
Sensitivity to hot or cold that lingers for minutes after the stimulus is removed (normal teeth stop hurting within seconds). Prolonged reaction signals pulp damage.
Discomfort or sharp pain when biting down on the tooth, indicating inflammation extending toward the root area.
Large, obvious cavity that clearly extends deep into the tooth toward the pulp chamber, or dental X-rays showing decay very close to or touching the pulp chamber.
Concerned about your child's tooth? Early evaluation prevents worsening infection.
Before the procedure, we examine your child's tooth and take X-rays to assess decay extent, root health, and surrounding bone. We discuss sedation options based on your child's anxiety level, age, 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.
We place a rubber dam (a thin rubber sheet) around the tooth to isolate it from saliva, keep it dry, and protect your child from the materials we use. First, we remove all the decayed tooth structure and clean out the cavity completely. This exposes the pulp chamber in the crown. We then carefully remove all the inflamed, infected pulp tissue from the crown portion of the tooth.
Next, we irrigate the chamber with antibacterial solution and check the pulp tissue at the root canal openings—healthy root pulp should have controlled bleeding that stops within a few minutes. Assuming the root pulp is healthy, we place a medicinal dressing over it using materials such as Ferric Sulfate, Formocresol (used less now), Mineral Trioxide Aggregate (MTA), or Biodentine. Each has specific properties:
This medicinal layer protects the root pulp, helps it heal, and seals it from bacteria. We then place a base material (usually zinc oxide eugenol or glass ionomer) over the medicinal dressing and fill the remaining cavity with regular filling material to seal the tooth.
This medicinal layer protects the root pulp, helps it heal, and seals it from bacteria. We then place a base material over the medicinal dressing and fill the remaining cavity. Finally, we place a crown—usually stainless steel for back teeth or esthetic crown for front teeth—over the tooth to protect it and restore full chewing function.
Time Required: Pulpotomy on a single baby tooth takes 20-35 minutes including tooth preparation, nerve treatment, filling, and crown placement. Multiple pulpotomies add approximately 20-25 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 1-2 days—this is inflammation resolving, not continued infection.
Children's ibuprofen or acetaminophen manages post-treatment discomfort effectively. Most children need pain medication only for the evening after treatment and perhaps the next day. If significant pain persists beyond 2-3 days or worsens, contact us.
Brush twice daily with fluoride toothpaste, including the crowned tooth. Floss daily between all teeth. Regular dental checkups every 6 months to monitor the tooth. Fluoride treatments at dental visits.
Once crowned, the tooth functions normally. Avoid chewing ice or very hard objects. Minimize very sticky foods (caramel, taffy) that could pull the crown loose. Normal diet is fine otherwise.
A successfully treated tooth should cause no pain and function normally for years until it naturally falls out. The tooth remains firmly in place, continues growing and developing normally, maintains proper space for the permanent tooth underneath, and your child completely forgets about the treatment.
Success rates for pulpotomy are high (80-95%) when root pulp was truly healthy at time of treatment, proper medicinal materials were used, crown provides good seal preventing bacterial re-entry, and regular monitoring with checkups continues.
The baby tooth will eventually fall out naturally—typically ages 10-12 for back molars, 6-8 for front teeth—with the crown attached, just like un-crowned teeth. The permanent tooth underneath erupts normally.
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When pulpotomy successfully saves a baby tooth, that tooth continues serving important functions for years—maintaining space, supporting proper jaw development, enabling normal chewing, and eventually falling out naturally when the permanent tooth is ready to erupt.
Per tooth, depending on complexity
Protective crown for back teeth
Tooth-colored option for front teeth
Total cost for pulpotomy plus crown ranges $450-800 per tooth for most cases. When multiple teeth require treatment under sedation, sedation fees are additional.
Most pediatric dental insurance plans cover pulpotomy 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—extraction requiring space maintainer ($300-500 additional), loss of chewing function, potential speech problems, and orthodontic complications from premature tooth loss—pulpotomy represents sound investment in your child's oral health and development.
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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