Pulpotomy for baby teeth — do baby teeth have nerves, and why save them?

Key facts

• Baby teeth have nerves, and their pulp is relatively large
• Pulpotomy removes the infected crown pulp and keeps the root pulp
• Usually followed by a stainless steel or zirconia crown
• Extraction may be preferred with abscess or a tooth close to falling out
• Saving baby molars helps chewing, speech and space for adult teeth

Do baby teeth have nerves?

Yes. Every baby tooth has a pulp in its centre containing nerves and blood vessels, just like an adult tooth. In fact, the pulp of a baby tooth is relatively large and the enamel and dentine around it are thinner, so decay can reach the nerve faster than in adult teeth. That is why a small-looking cavity in a baby molar can sometimes cause pain or infection quickly. As the adult tooth develops underneath, the roots of the baby tooth gradually dissolve, which is part of the natural process that lets the baby tooth loosen and fall out at the right time.

What a pulpotomy is

A pulpotomy removes the inflamed or infected pulp from the crown part of the tooth while keeping the pulp in the roots alive. After numbing the tooth, the dentist removes the decay and the top portion of the pulp, controls the bleeding, and places a medicament over the remaining root pulp to help it heal. The tooth is then sealed and usually covered with a stainless steel or zirconia crown, because the tooth is weaker afterwards. It is often completed in a single visit. A pulpotomy is suitable when the root pulp is still healthy; signs of wider infection may need a different treatment.

Pulpotomy vs extraction

Not every baby tooth with nerve involvement can or should be saved. A pulpotomy is usually considered when the tooth has decay into the nerve but no abscess, no significant bone loss on the X-ray, enough tooth left to restore, and a reasonable time before it would naturally fall out. Extraction may be advised when there is extensive infection, swelling, root resorption, a tooth close to falling out, or a child who cannot cooperate with treatment. If a back baby tooth is removed early, a space maintainer may be recommended to stop neighbouring teeth drifting into the space.

Why saving baby teeth matters

Baby molars often stay in the mouth until around ten to twelve years of age. During that time they help children chew a varied diet, support clear speech, and act as natural space holders that guide the adult teeth into position. Losing them early can allow teeth to tip and shift, which may lead to crowding or impacted adult teeth later. A pulpotomy can relieve pain, remove infection risk from that tooth and keep it functioning until it is ready to go. It also spares a young child the experience of an extraction where one is avoidable.

Aftercare and warning signs

After treatment, the lip and cheek stay numb for one to three hours, so watch your child to prevent biting and offer soft food once feeling returns. Mild soreness can be managed with children's paracetamol or ibuprofen at the dose for their weight. Brush gently around the crown twice a day with fluoride toothpaste. Regular check-ups with periodic X-rays allow the dentist to confirm the tooth stays healthy. Contact the clinic if there is swelling, a pimple-like bump on the gum, a loose crown or persistent pain. Facial swelling with fever needs same-day care.

Positive early visits shape a child's attitude to dentistry for life. We keep appointments short, explain everything in child-friendly language, and focus on prevention.

Prepared by the Manhal Medical Center editorial team · Updated: 2026-10-18 · Treating specialist: Dr. Fariba Alnoory

This page is general information and does not replace a consultation. Suitability, risks and results vary between patients.