Pulpotomy: Uses, side effects, and procedure

What is a pulpotomy?

Inside every tooth, there's a soft little core called the pulp. That's where the magic happens. It is filled with nerves, blood vessels, tiny connective fibres, all the stuff that keeps your tooth alive and responsive. It's sensitive and delicate. When decay or bacteria sneak their way in? Oh, you'll know. The pain can be sharp. Sometimes dull. Other times, it throbs like a heartbeat in your jaw. Enough to keep you awake at 2 a.m., wondering what went wrong.

That's when a pulpotomy usually comes into play. Kind of like a rescue mission. The dentist doesn't go deep into the tooth like in a root canal. No, it's more selective than that. They only remove the infected bit, the coronal pulp, the part sitting up in the crown. But leave the healthy pulp in the roots untouched. Safe, alive, and still doing its job.

After that, they'll clean things out, disinfect the chamber, and place a medicated layer over the remaining pulp. It's soothing, like wrapping a sore muscle. The goal is to calm it down and stop bacteria from coming back. Then, a filling or crown goes on top to seal the deal and keep it strong.

In kids, this is done all the time. Baby molars, especially, need to stay put until it's time for the adult teeth to come in. In grown-ups, it's a bit different. A pulpotomy can sometimes buy you time, delaying a full root canal if the infection hasn't burrowed too deeply. A middle ground, really. Not the end, not the beginning, just a way to save what's still worth saving.

Is a pulpotomy painful?

Here's the truth: no, it shouldn't be painful, though the fear of pain often makes people delay treatment.

The procedure is done under local anaesthesia, so you'll feel pressure but not pain. The real discomfort usually comes before the treatment, from the infection itself. Once the inflamed pulp is removed, most patients actually feel immediate relief.

Afterward, there might be mild tenderness for a few days, but it's easily managed with over-the-counter painkillers and soft foods.

So if you're wondering whether a pulpotomy hurts, the short answer is: not nearly as much as leaving the infection untreated.

Who needs a pulpotomy?

You might need a pulpotomy if:

For children, pulpotomy is often the go-to treatment for saving primary (baby) molars. It keeps the tooth functioning, maintains spacing for the adult tooth, and avoids unnecessary extraction.

For adults, it's a bit more situational; your dentist may suggest a pulpotomy if only the upper pulp is affected, and the roots are still viable. It's a conservative, tooth-saving step before a full root canal becomes necessary.

Can you avoid it and go a different route?

Sometimes… yes. If you can catch the symptoms early on, you can go towards a simpler procedure.

Like if decay is still shallow, it hasn't yet reached that soft pulp layer. Your dentist might fix it with a simple filling or maybe an indirect pulp cap. This acts like a little shield over the sensitive area. That's why those routine check-ups matter more than people think. They catch things before they turn into emergencies.

But when the pain runs deep, sharp, and unrelenting, that's your tooth waving a white flag. At that point, skipping a dental pulpotomy doesn't save you from pain; it just postpones something worse. An untreated infection can spread fast. This leads to swelling, abscesses, and even bone loss. And before you know it, you're looking at a full root canal… or losing the tooth altogether.

Natural remedies? Wishful thinking when it's this far along. They might soothe symptoms for a bit, but they can't stop bacteria from burrowing into the pulp. The real goal isn't to avoid treatment. It's to save the tooth while you still can. Because once that chance slips away, there's no going back.

What does the pulpotomy procedure look like?

It sounds intense, but in reality, a pulpotomy is a pretty quick and controlled process. Most appointments take no more than 30 to 45 minutes from start to finish.

Step 1. Numbing the tooth

First things first, your dentist will numb the area using local anesthesia. You'll stay awake, but you won't feel any pain. Just a little pressure here and there.

Step 2. Creating access

Once you're numb, the dentist makes a tiny opening in the tooth to reach the pulp chamber. It's done carefully to keep as much of your natural tooth as possible intact.

Step 3. Removing the infected pulp

Now comes the cleanup. The infected portion of the pulp (the upper part, called the coronal pulp) is removed. The healthy part deeper inside the root is left untouched.

Step 4. Cleaning and disinfecting

The empty chamber is then disinfected to eliminate bacteria and prevent further infection. This step is key to helping the tooth heal properly.

Step 5. Applying the medicated dressing

A medicated dressing, often made with formocresol or mineral trioxide aggregate (MTA), is placed inside the tooth. It soothes the remaining pulp and encourages healing.

Step 6. Sealing the tooth

Finally, the tooth is sealed with a durable filling or covered with a crown to protect it from new decay or damage.

Step 7. After the procedure

You might feel a little numbness or mild tenderness once the anesthesia fades, but that's temporary. Most people go right back to their normal routine the same day.

Is recovery long?

Not at all. Most people go back to their routine the same day. You might feel mild soreness or sensitivity, but it fades within a few days.

Stick to soft foods for the first 24 hours, avoid chewing on that side, and maintain good oral hygiene, brushing gently around the treated tooth.

Your dentist might schedule a follow-up visit to ensure healing is on track.

Are there any risks involved?

Like any medical procedure, a tooth pulpotomy carries some risks, but they're rare.

The most common include:

But with modern materials and proper technique, success rates are impressively high, over 90% for both children and adults when done early.

The bottom line

A pulpotomy isn't something to fear; it's something to appreciate. It's your dentist's way of saying, “We can still save this tooth.”

By acting early, you preserve more of your natural tooth, avoid the cost and complexity of a root canal, and keep your smile pain-free.

So the next time that dull ache appears, don't wait it out. Sometimes, relief comes not from avoiding treatment, but from taking care of the tooth that's been quietly asking for help.

Frequently asked questions

What are the side effects of a pulpotomy? +

After a pulpotomy, you might feel a bit of sensitivity or mild discomfort around the treated tooth. Some people notice slight swelling or gum tenderness, but these side effects usually go away within a few days. Serious problems are uncommon when the procedure is done properly.

What is the recovery like after a pulpotomy? +

Recovery from a pulpotomy is usually quick and easy. Most people can go back to their normal routine the same day. The numbness will wear off after a few hours, and any soreness typically fades within one to two days. Keeping the area clean and avoiding very hard foods can help it heal faster.

Is a pulpotomy painful? +

No, a pulpotomy is not painful. Your dentist will numb the area completely before starting. You may feel slight pressure during the procedure, but not pain. Afterward, the tooth might feel a bit sore or sensitive for a short time, but it’s very manageable with basic pain relief if needed.

Can I eat after a pulpotomy? +

Yes, you can eat after a pulpotomy, but it’s best to wait until the numbness goes away. Start with soft foods like soup, rice, or yogurt, and avoid anything very hard or sticky for at least a day. This helps prevent discomfort and allows the treated tooth to settle.

How long does a pulpotomy last? +

A pulpotomy can last for many years if the tooth is properly restored and well cared for. In children, it usually lasts until the baby tooth naturally falls out. In adults, it can help preserve the tooth for a long time, especially when supported with a dental crown and good oral hygiene.

Does a pulpotomy remove the nerve? +

No, a pulpotomy does not remove the entire nerve. It only removes the infected or inflamed part of the pulp in the crown of the tooth. The healthy nerve tissue in the roots remains in place, so the tooth stays alive and functional.