What Is a Pulpectomy? A Root Canal for a Milk Tooth

When decay reaches the nerve of a milk tooth, the nerve becomes infected. A pulpectomy removes that infected tissue, disinfects the canals inside the root, and fills them. The tooth stays in the mouth and keeps doing its job.

Keeping the tooth matters because a milk molar holds space for the permanent tooth beneath it. If it is lost years too early, the teeth beside it lean into the gap and the permanent tooth can come through crooked or blocked. That is a route into orthodontic treatment that could have been avoided. See the best age for braces for how that plays out later.

If the tooth is very close to falling out, or the infection has destroyed too much of it, removal is the better choice. The dentist decides this from the exam and an X-ray, not on a fixed rule.

The idea is the same, the details are not. Milk tooth roots are thin, curved and slowly dissolve as the permanent tooth pushes up beneath them. The filling material therefore has to be something the body can absorb along with the root, not the permanent filling used in adult teeth.

In an adult, the root canal has to last for life. In a milk tooth it only has to last until the tooth is shed, which is a few years at most. For the adult procedure, see our guide on whether a root canal hurts.

A pulpectomy treats a tooth whose nerve is infected or dead. A related, shallower treatment called a pulpotomy removes only the top part of the nerve when the infection has not gone deep. Which one a tooth needs is decided at the chair, once the decay is cleaned out and the nerve is seen.

An X-ray first, to see the root, the surrounding bone and the permanent tooth beneath. The tooth is then numbed with local anaesthetic, and the dentist usually places a small rubber sheet around it to keep it clean and dry.

The decay is removed, the nerve chamber is opened, and the infected tissue is taken out of the canals. The canals are rinsed and filled with the absorbable material. The tooth is then restored, and in most cases a stainless steel or tooth-coloured crown is placed because a milk molar treated this way is more brittle than before.

Many pulpectomies are done in one visit. Some need two, especially if the tooth is badly infected or the child tires. Settling the child, explaining each step in plain words and working in short stretches is part of the treatment, not an extra. The broader approach is described on our kids dentistry page.

A tooth that has been painful at night or on biting, or that was painful and then stopped hurting, which usually means the nerve has died rather than recovered. A pimple-like bump on the gum beside the tooth that comes and goes. Swelling of the gum or face. A tooth that has turned grey or dark compared with its neighbours.

Some children show none of these. The need is sometimes found only on a routine X-ray, which is another reason a regular check-up is worth keeping. Most of these cases start as an untreated cavity, covered in cavities in milk teeth.

A swelling that spreads across the face, fever with a swollen face, or any difficulty swallowing or breathing needs the same-day medical attention described in the next section.

The mouth stays numb for a couple of hours, so keep the child from chewing the cheek or lip and give soft food until it wears off. Mild soreness afterwards is common. Paracetamol as directed on the label for the child's age and weight is usually enough. Check with a doctor or pharmacist if the child has any other condition.

Seek care the same day for swelling, fever or a child who cannot eat or drink. If breathing or swallowing is affected, go to a hospital emergency.

Pricing for children's treatment follows the procedure, not the age of the patient. Call the clinic for a current price on a pulpectomy. For a comparison point, the root canal cost page shows how adult root canals are priced in Lucknow in 2026.