Pediatric Dental Pulp Therapy: A Complete Guide for Parents

Medically reviewed by Dr. Boris Kleyman, Pediatric Dentist

What is It | What is Dental Pulp | Signs of Damaged Dental Pulp | Pulpotomy vs. Pulpectomy | Is It Safe

Pediatric Dental Pulp Therapy

Dental pulp therapy is a dental procedure used to treat trauma in a tooth. It is another term for a root canal. The treatment restores the tooth and prevents it from being entirely lost or removed.

Children may need dental pulp therapy for baby teeth or permanent (adult) teeth. While baby teeth fall out, premature loss can be damaging to their development and the proper growth of permanent teeth, so the dentist will attempt to preserve a baby tooth if possible.

Pulp therapy – or root canal – is necessary when the pulp inside the tooth has been damaged. This can happen to due to a traumatic injury to the tooth, or due to severe dental decay.

If your child’s dentist has recommended dental pulp therapy, you may be looking for answers: this guide has information about pediatric dental pulp therapy – what it is, how it works, and what to know!

What is Pediatric Dental Pulp Therapy?

Dental pulp therapy is a dental treatment that helps to preserve the tooth by treating damage to the interior of the tooth, or pulp. Pulp therapy is a necessary treatment when the dental pulp has become exposed or infected, due to injury or severe dental decay. The pulp is protected by several layers of dental material, but in extreme cases of trauma or decay, the pulp is damaged, requiring pulp therapy to correct.

Dental pulp therapy is also called a root canal. This procedure is done to protect and preserve the tooth, so that it does not need to be removed.

Children can receive pulp therapy; pediatric dentists perform pulp therapy on both baby teeth and permanent teeth. Even though baby teeth will eventually fall out, dentists try to preserve them if possible, to keep your child’s smile healthy and developing properly.

Pediatric dental pulp therapy is very safe, and done with careful supervision from licensed professionals. Your child will be given local anesthesia to prevent pain during the procedure, and/or laughing gas (nitrous oxide) to calm and soothe them. You can ease your child’s anxiety about dental pulp therapy (root canal) by understanding the procedure yourself, talking with them about what to expect, and soothing them before and after the procedure.

What is Dental Pulp?

The dental pulp is the interior of the tooth, which resides under the hard dental enamel exterior and the dentin layer between them.

The pulp connects the tooth to the root system that keeps it alive – the blood flow, nerve system, and the rest of the body. The pulp isn’t solid. Rather, it is a mix of water, tissue, nerves, and blood vessels.

Normally, you would never see the dental pulp – it is protected by the exterior of the tooth, while the pulp keeps oxygen and blood flowing through the tooth itself on the inside. In a healthy tooth, you can’t feel or see the pulp.

But when a tooth is damaged – either by trauma to the mouth or severe dental decay in the tooth, the pulp can become exposed, which puts the entire tooth at risk and can cause extreme pain and sensitivity.

What Are Signs of Damaged Dental Pulp?

Generally, the best indication that the pulp has been damaged or exposed is pain. Your child may
Indicate general pain in their mouth, or a specific tooth that hurts. They may also complain of jaw ache, headache, or inflamed and sensitive gums.

Sensitivity to heat or cold on the tooth is also a sign of potential pulp damage.

Other signs of potentially damaged dental pulp:

  • Difficulty sleeping due to pain
  • Sensitivity to hot and/or cold foods/beverages
  • Swelling, redness, or sensitivity of the gums

If your child has dental pain or has sustained an injury to the mouth, contact your pediatric dentist right away for examination.

Prompt treatment of damaged dental pulp can make the difference between saving the tooth and necessary removal.

Pulpotomy vs. Pulpectomy: What’s the Difference?

The procedure for pulp therapy depends on the severity of damage to the pulp and the determination of your child’s dentist. The dentist will take x-rays to establish which type of pulp therapy is best for the specific condition of the tooth.

The two types of pulp therapy are pulpotomy and pulpectomy.


A pulpotomy is less invasive than a pulpectomy, and is used when the root of the tooth has not yet been affected. In a pediatric pulpotomy, the dentist will remove only the infected pulp from the crown of the tooth (the crown is the part you can see in the mouth). They will fill the evacuated area with a compound material, which prevents further infections and calms the inflammation in the tooth. Afterwards, the dentist may place a crown on the top of the tooth to prevent future decay. This procedure generally requires only local anesthesia, inserted at the gum line at the site of the pulpotomy. Nitrous oxide (laughing gas) may also be administered, which causes a pleasant, soothing sensation that is calming for patients of all ages.


A pulpectomy is a root canal. With this procedure, the dentist removes all the pulp, which has become infected and cannot be saved. The diseased pulp is evacuated from the tooth, throughout the crown and root, and replaced with a biocompatible material that serves the same purpose as the pulp of the tooth.

Pulpectomy is less common for baby teeth, but may be done to preserve a very damaged tooth, to prevent it from being lost too early and disrupting the healthy development of the permanent adult teeth. This is also called a “baby root canal.”

Is Dental Pulp Therapy Safe for Children?

Yes, dental pulp therapy is a safe procedure for children, and will only be done under direct supervision by your child’s dentist and dental team. Dental pulp therapy is only used when necessary; there are other less invasive methods to protect a child’s damaged tooth for less severe cases.

When performing dental pulp therapy or a root canal on your child, the dentist and their team will use appropriate anesthetics to ensure the process is as comfortable as possible. Your child may also be prescribed limited amounts of pain medication afterwards to ease discomfort after the procedure.

For very anxious children, those with special needs who may require it, or children undergoing multiple procedures, the dentist may recommend sedation dentistry, which involves full sedation under the supervision of a licensed anesthetist doctor. Talk to your child’s dentist about sedation dentistry if you think this might be a good option for your child.

Dental treatments can be frightening for children, but you can help soothe them and calm their fears by understanding the procedure yourself, and explaining to them what is happening. And maintaining a great oral healthcare routine will help keep your child’s teeth healthy and smiling, and reduce the need for more invasive procedures.