The procedure that saves severely infected baby teeth — and protects your child's permanent teeth beneath them.
Pulpectomy: Quick Answer
A pulpectomy is the pediatric equivalent of a root canal — performed on baby (primary) teeth. It removes infected pulp tissue from all root canals of the tooth, fills them with a resorbable material (most commonly zinc oxide-eugenol paste), and seals the tooth, usually under a stainless steel crown. Unlike an adult root canal, the filling material is designed to slowly resorb as the permanent tooth erupts beneath it. A well-done pulpectomy preserves a functional baby tooth for years, maintaining the jaw spacing that permanent teeth depend on.
Key facts
A pulpectomy is the pediatric equivalent of a root canal — but for baby teeth. It removes infected pulp from all root canals of a primary (milk) tooth, fills the canals with a resorbable material (usually zinc oxide-eugenol paste), and seals the tooth, usually under a stainless steel crown. Unlike adult root canals, the filling material is designed to resorb as the permanent tooth erupts beneath it. A well-done pulpectomy can keep a baby tooth functional for years, preserving jaw spacing for adult teeth.
Baby teeth are not simply placeholders. They maintain the arch space that permanent teeth need to erupt in the correct position. When a baby molar is lost early — due to extraction of an infected tooth that could have been saved — the neighbouring teeth drift into the gap. This causes crowding, impaction, or misalignment of permanent teeth. A pulpectomy exists because, in many cases, saving an infected baby tooth is genuinely better for your child's long-term dental development than extracting it.
A pulpectomy is indicated when infection has progressed beyond the crown of the tooth into the root canals. Clinical signs include: a dental abscess (swelling, pus), a sinus tract (small pimple on the gum), spontaneous or night pain, significant pain on tapping the tooth (percussion), tooth mobility beyond what is normal, or X-ray evidence of furcation involvement or periapical changes. If only the coronal pulp is affected, a simpler pulpotomy may suffice. A periapical X-ray is mandatory before deciding.
Pulp Chamber
The hollow space inside the crown of the tooth containing nerves and blood vessels. In an infected baby tooth, bacteria have reached this space — causing inflammation, pain, and if untreated, eventual abscess formation.
Root Canals
Narrow channels running down each root, housing pulp tissue. A pulpectomy removes pulp from ALL canals — unlike a pulpotomy, which only addresses the coronal (crown-level) pulp. Baby molars typically have two or three root canals.
ZOE Paste
Zinc oxide-eugenol, the most widely used resorbable filling material for primary tooth pulpectomies. It slowly dissolves as the permanent tooth pushes up from below, unlike gutta-percha used in adult root canals, which is non-resorbable and would obstruct eruption.
Stainless Steel Crown
A preformed metal cap placed over the tooth after a pulpectomy. It protects the structurally weakened tooth from fracture and provides a durable, leakage-free restoration that lasts until the baby tooth naturally exfoliates.
Furcation Area
The point on a multi-rooted baby molar where the roots divide. X-ray evidence of bone loss or infection at the furcation — called furcation involvement — is one of the key diagnostic signals that a pulpectomy (or extraction) is required, rather than the simpler pulpotomy.
Sources
A step-by-step walkthrough of what the dentist does — and what your child experiences.
⏱ 60–90 minutes for pulpectomy + SSC placement, typically completed in one visitA periapical X-ray is taken to assess root anatomy, root length, and signs of infection — particularly furcation involvement (bone loss between the roots) and periapical pathology. The dentist also takes a pain history (spontaneous pain, night pain, swelling), checks tenderness on gentle percussion of the tooth, assesses soft tissue for abscess or sinus tract, and evaluates tooth mobility.
A periapical X-ray is non-negotiable before any pulp therapy decision. If your child's dentist recommends a pulpectomy without taking an X-ray first, ask why — it cannot be properly diagnosed without one.
Topical anaesthetic gel (EMLA cream or benzocaine gel) is applied to the gum for 1–2 minutes before the injection to minimise needle sensation. Infiltration or inferior alveolar nerve block anaesthesia is then administered depending on the tooth location. Experienced pediatric dentists use behaviour management techniques — tell-show-do, distraction, calm narration — to reduce anxiety and make the injection as comfortable as possible.
If your child is highly anxious or very young, ask about nitrous oxide (laughing gas) sedation. Many pediatric dental clinics in India now offer it and it dramatically improves the experience without the risks of general anaesthesia.
A rubber dam — a sheet of latex or non-latex material with a hole punched for the tooth — is clamped around the tooth. It keeps the operating field dry, prevents irrigating solutions from entering the child's mouth, and stops the child from accidentally swallowing instruments or materials. Rubber dam use is a non-negotiable marker of proper pulpectomy technique.
If a dentist performs a pulpectomy without rubber dam isolation, the procedure quality is seriously compromised. Rubber dam use is the standard of care.
An access cavity is drilled through the top of the tooth to reach the pulp chamber. All coronal pulp tissue is removed with spoon excavators and barbed broaches. The root canals are identified and the root pulp is removed using K-files worked to the appropriate working length (estimated from the X-ray, since apex locators are less reliable in primary teeth). Canals are irrigated with dilute sodium hypochlorite (NaOCl) and sterile saline to remove debris and disinfect.
Canals are dried with paper points and filled with zinc oxide-eugenol paste, which is the most widely validated resorbable filling material for primary teeth. Some protocols use Vitapex (calcium hydroxide + iodoform) or MTA — both are acceptable alternatives with strong evidence. The paste should fill to within 1–2mm of the radiographic apex without overfilling beyond the apex, which can cause irritation of the developing permanent tooth bud.
A post-operative X-ray confirming adequate fill length is good practice. Ask your dentist to show it to you.
The tooth is prepared by trimming the sides slightly to allow the crown to seat. The appropriate SSC size is selected from a kit (based on the mesio-distal width of the tooth), crimped and contoured to fit the gingival margin, and cemented with glass ionomer cement. The crown is seated with firm pressure and the child bites down to ensure full seating. Excess cement is removed. SSC placement is usually done in the same appointment as the pulpectomy.
A stainless steel crown after pulpectomy is not optional — it is essential. An untreated or composite-filled pulpectomy tooth is far more likely to fracture or leak and fail. If a dentist offers to 'skip the crown to save money,' consider it a red flag.
Stainless steel crown adds ₹800–₹2,000. Total treatment cost is usually ₹3,000–₹8,000 per tooth. Prices are higher at specialty pediatric dental clinics and multi-specialty hospitals; lower at general dental practices and government hospitals.
Based on Capcane's 2026 review of pediatric dental clinic pricing across Bangalore.
How much does a pulpectomy cost in Bangalore for a molar vs a front tooth? Front teeth (incisors) are simpler — one root, one canal. Molars are more complex with two or three roots and multiple canals, which takes more time and materials.
| Tooth type | Procedure | SSC | Total |
|---|---|---|---|
| Front tooth (incisor) | ₹2,000–₹3,000 | ₹800–₹1,200 | ₹2,800–₹4,200 |
| Premolar | ₹2,500–₹4,000 | ₹1,000–₹1,500 | ₹3,500–₹5,500 |
| Molar (most common) | ₹3,500–₹6,000 | ₹1,200–₹2,000 | ₹4,700–₹8,000 |
Dentist qualification
An MDS Pediatric Dentist charges more than a general dentist, but is better trained in child behaviour management and primary tooth anatomy. For cooperative children with straightforward cases, a skilled general dentist may deliver a good outcome. For anxious children, young children (under 5), or complex cases, an MDS Pediatric Dentist is the safer choice.
Filling material used
ZOE paste is the most common and least expensive filling material. Vitapex and MTA-based protocols cost slightly more. The clinical evidence for all three is reasonable; ZOE remains the most widely validated option in long-term studies on Indian populations.
Stainless steel crown
The SSC is almost always necessary after a pulpectomy. Confirm it is included in the quoted price or ask for it separately. Omitting the crown to save money is false economy — the tooth is likely to fracture or the pulpectomy to leak and fail without it.
Clinic type
Standalone pediatric dental clinics and multi-specialty hospitals typically charge ₹4,000–₹8,000 total. General dental practices charge ₹3,000–₹5,500. Government dental hospitals (with MDS Pedodontics departments) may offer the procedure at significantly subsidised rates.
Red flags — watch out for these
The most important decision parents face when told their child needs a pulpectomy is: should we save the tooth or just extract it? The honest answer depends on the specific tooth, the child's age, and the extent of infection — not on the dentist's preference or the family's budget alone.
Signs you genuinely need it
Signs you might not need it
Capcane's position
Share your child's dental X-ray and any clinical photos with us. We will review whether the pulpectomy is the right call for that specific tooth, confirm the diagnosis is supported by the X-ray findings, and help you understand what to expect from the procedure.
Second opinion on extraction vs pulpectomy
Share your child's X-ray and the dentist's recommendation. An MDS Pediatric Dentist on our panel will review whether the pulpectomy is clinically indicated, whether extraction is being recommended too readily, or whether the infection is too advanced for pulpectomy to succeed. We give you an honest, evidence-based view — not one influenced by what is easier or more profitable to perform.
Clinic vetting for child-friendly protocols
We assess pediatric dental clinics on specific criteria: MDS-qualified dentist, rubber dam use, availability of behaviour management (tell-show-do, nitrous oxide), and adherence to post-operative X-ray and recall protocols. We do not refer to clinics simply because they have good marketing or high patient volumes.
Transparent cost comparison
We provide a realistic cost breakdown for your city — procedure fee, SSC, any follow-up visits — so you know what a fair price looks like before you walk into the clinic. We flag when quoted prices seem significantly out of range in either direction, and explain what is typically included vs what is often charged separately.
Real outcomes from real patients.
Kavitha R.
“My 7-year-old had a dental abscess and our local dentist immediately said to extract the tooth. I wasn't comfortable with that and contacted Capcane. They reviewed the X-ray and said the tooth could be saved with a pulpectomy. We found a pediatric dentist they recommended — the whole procedure was done in one sitting, my daughter barely felt anything, and she's been absolutely fine since. The tooth is still there 8 months later with no issues.”
Suresh M.
“My son was waking up at night with tooth pain. The dentist we first went to quoted ₹9,000 for the pulpectomy and crown which seemed very high. Capcane helped us understand what a fair price looks like and confirmed the treatment was appropriate. We found a good pediatric dentist within our budget — ₹5,500 total including the crown. The dentist was great with my son, used rubber dam and everything. Would have been lost without the guidance.”
Get a free, honest second opinion — no commitment, no hidden fees.