Pulpotomy: Procedure, Recovery, Benefits and Risks
Updated: 3 days ago
Written and medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: November 2026 · How we review
Quick Answer: What is a pulpotomy?
A pulpotomy is a dental procedure that removes unhealthy pulp from the crown (top part) of a tooth while leaving the root in place. It's often called a baby root canal because it's mostly done on baby molars. The dentist places a medicated filling and seals the tooth with a crown. It takes 30 to 45 minutes. [1]
What the research says
Pulp treatment for decayed baby teeth usually works. A Cochrane review of 87 randomized trials (7,140 teeth) found low failure rates overall. For pulpotomy, mineral trioxide aggregate (MTA) led to fewer clinical and X-ray failures than formocresol (12 trials, 740 participants), and formocresol carries known toxicity concerns. The trials were small and at unclear or high risk of bias. (Smaïl-Faugeron et al., Cochrane Database of Systematic Reviews, 2018) [2]
MTA ranked as the most likely best pulpotomy material. A network meta-analysis of 43 randomized trials in baby molars compared seven medicaments and techniques. MTA, Biodentine and laser outperformed formocresol, ferric sulfate and sodium hypochlorite, calcium hydroxide performed worst, and MTA ranked first for nearly every outcome. (Guo et al., Clinical Oral Investigations, 2023) [3]
Key takeaways
A pulpotomy removes damaged pulp from the crown of a tooth and keeps the root. [1]
It is mostly used on baby (primary) molars and is often called a baby root canal. [1]
Adults may be offered a pulpotomy as an alternative to a root canal. [1]
The procedure takes about 30 to 45 minutes and ends with a dental crown. [1]
If not all unhealthy pulp is removed, another pulpotomy, a pulpectomy or an extraction may be needed. [1]
What is a pulpotomy?
Your teeth have a soft inner layer called pulp, which holds nerves and blood vessels. When tooth decay reaches the pulp in the crown of a tooth, the pulp can become inflamed or infected and cause pain. During a pulpotomy, a dentist or endodontist removes the unhealthy pulp from the crown, places medicated material and leaves the root in place. [1]
A pulpotomy treats the top of the tooth and keeps the root.
This is different from a root canal or a pulpectomy, which remove pulp from the root canals as well.
Who needs a pulpotomy?
A pulpotomy is most often done on primary (baby) teeth, especially the back molars, when tooth decay has reached the pulp inside the crown. Saving the baby tooth matters because it holds space for the permanent tooth underneath. Most children lose their back baby teeth between ages 9 and 12. [1]
Adults can have a pulpotomy too. A dentist may recommend it as an alternative to a root canal in some cases. [1]
What happens during a pulpotomy?
A pulpotomy is done in the dental chair and usually takes about 30 to 45 minutes. [1]
Each step protects the tooth while the damaged pulp is removed.
Your dentist gives a numbing shot near the tooth and gum. Children may also get liquid sedation first.
A thin rubber dental dam is placed around the tooth to keep it dry.
A small hole is drilled in the top of the tooth to reach the pulp.
The unhealthy pulp in the crown is removed, and the root is left in place.
A medicated filling is placed inside the tooth.
The top of the tooth is sealed with dental cement.
A dental crown is placed right away or after a few weeks, once the dentist confirms the infection has cleared.
Sources: [1]
Pulpotomy at a glance
Item | Typical detail |
Main patients | Children with decayed baby molars; some adults |
What is removed | Unhealthy pulp in the crown of the tooth |
What is kept | The root and root pulp |
Numbing | Numbing shot; liquid sedation possible for children |
Procedure time | About 30 to 45 minutes |
Final step | Dental crown, now or after a few weeks |
Sources: [1]
Pulpotomy vs. pulpectomy vs. root canal
These procedures all treat damaged pulp, but they differ in how much pulp is removed.
Feature | Pulpotomy | Pulpectomy or root canal |
Pulp removed | Pulp in the crown only | Pulp in the crown and roots |
Root pulp | Left in place | Removed |
Usual teeth | Mostly baby molars | Baby teeth (pulpectomy) or adult teeth (root canal) |
If a pulpotomy does not remove all the unhealthy pulp, your dentist may suggest a pulpectomy or extraction next. [1]
What are the benefits and risks of a pulpotomy?
A pulpotomy is considered very safe and has few risks. [1]
Benefits | Risks |
Relieves pain from inflamed pulp | Unhealthy pulp may be left behind |
Stops infection from spreading | A repeat pulpotomy may be needed |
Keeps the baby tooth and its root in place | A pulpectomy or extraction may be needed |
Sources: [1]
Untreated pulp infection can spread and lead to a tooth abscess, so prompt care matters.
What is recovery like after a pulpotomy?
Recovery time depends on the type of anesthesia or sedation used. Numbing medicine usually wears off within a few hours, while sedation can take up to 24 hours to wear off. [1]
Recovery depends on the numbing or sedation used.
The filling or crown is expected to last until the permanent tooth replaces the baby tooth. [1]
When should you call your dentist?
Contact your dentist after a pulpotomy if you or your child have: [1]
Severe pain that medication does not relieve
Swelling of the face or jaw
Fever, chills or other signs of infection
Conclusion
A pulpotomy is a quick, safe way to save a tooth when decay has reached the pulp in its crown. By removing only the damaged pulp and keeping the root, it relieves pain, stops infection from spreading and lets a baby tooth hold its place until the adult tooth comes in.
If your child's dentist recommends a pulpotomy, ask which material will be used and whether the crown will be placed the same day. Watch for severe pain, swelling or fever afterward and call the dentist if they appear.
Keep learning: Read our guide to Pulpitis: Managing Dental Inflammation and Sensitivity to understand what inflames the pulp, or visit the American Academy of Pediatric Dentistry for more about children's dental care.
FAQ
What is a pulpotomy?
A pulpotomy is a dental procedure that removes unhealthy pulp from the crown of a tooth while leaving the root in place. [1]
Why is a pulpotomy called a baby root canal?
It is mostly done on baby teeth and, like a root canal, it removes damaged pulp. Unlike a root canal, it leaves the root pulp in place. [1]
Is a pulpotomy only for children?
No. It is mostly done on baby molars, but adults may be offered a pulpotomy as an alternative to a root canal. [1]
How long does a pulpotomy take?
The procedure takes about 30 to 45 minutes. [1]
Does a pulpotomy hurt?
A numbing shot is given near the tooth first, and children may also receive liquid sedation, so the procedure itself should not be painful. [1]
Does a pulpotomy need a crown?
Yes. A dental crown is the final step. It may be placed right away or after a few weeks to confirm the infection is gone. [1]
How long is recovery after a pulpotomy?
Numbing medicine wears off within a few hours. Sedation can take up to 24 hours to wear off. [1]
How long does a pulpotomy last?
The filling or crown should last until the permanent tooth replaces the baby tooth. Most children lose their back baby teeth between ages 9 and 12. [1]
What if a pulpotomy fails?
If not all the unhealthy pulp was removed, your dentist may recommend another pulpotomy, a pulpectomy or an extraction. [1]
When should I call the dentist after a pulpotomy?
Call for severe pain that medicine does not relieve, swelling of the face or jaw, or fever, chills or other signs of infection. [1]
How do I prepare for a pulpotomy?
Most adults do not need to do anything to get ready. If you feel anxious about dental work, tell your dentist, who can suggest ways to manage it. Children may feel more nervous, and their pediatric dentist may suggest things you can do to help your child feel calmer [1].
Related Reading
When decay reaches the pulp: Root Canal Treatment
Removing pulp from baby tooth roots: Pulpectomy for Children: Procedure and Aftercare
Inflamed dental pulp: Pulpitis Decoded: Managing Dental Inflammation and Sensitivity
When the pulp dies: Pulp Necrosis: Understanding the Causes and Treatments for Dead Teeth
The cause behind most pulp damage: Cavities and Tooth Decay: Symptoms, Causes, Diagnosis and Treatment
When infection spreads: Tooth Abscess: Symptoms, Causes, Diagnosis, and Treatment
References
Cleveland Clinic. Pulpotomy: Procedure & Recovery. Cleveland Clinic. Last updated August 13, 2025. https://my.clevelandclinic.org/health/procedures/pulpotomy
Smaïl-Faugeron V, Glenny AM, Courson F, et al. Pulp treatment for extensive decay in primary teeth. Cochrane Database Syst Rev. 2018;5(5):CD003220. PMID 29852056. https://doi.org/10.1002/14651858.CD003220.pub3
Guo J, Zhang N, Cheng Y. Comparative efficacy of medicaments or techniques for pulpotomy of primary molars: a network meta-analysis. Clin Oral Investig. 2023;27(1):91-104. PMID 36580161. https://doi.org/10.1007/s00784-022-04830-1
Medical disclaimer
This article is for general education only and does not replace advice from a qualified dentist or healthcare professional. Talk to your dentist about your own or your child's treatment, and seek care promptly for severe pain, facial swelling or fever.
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