The simpler, faster baby tooth procedure — when the infection hasn't yet reached the roots.
Pulpotomy: Quick Answer
A pulpotomy removes the infected coronal pulp — the pulp tissue inside the crown of the tooth — while leaving the root pulp intact. A medicament (MTA, ferric sulphate, or formocresol) is applied to the root canal orifices to preserve the remaining healthy pulp, and a stainless steel crown is placed to protect the tooth. It is faster, simpler, and less expensive than a full pulpectomy. It is appropriate when infection is confined to the crown — when root canals are also infected, a pulpectomy is needed instead.
Key facts
A pulpotomy removes only the infected coronal pulp (the portion inside the crown) while leaving the root pulp intact. It is faster, simpler, and less invasive than a pulpectomy. A medicament — formocresol, ferric sulphate, or MTA — is applied to the root canal orifices to fix or preserve the remaining pulp, and a stainless steel crown is placed over the tooth. Pulpotomy is suitable when infection hasn't reached the root canals. When root pulp is also infected, a full pulpectomy is needed.
Pulpotomy exists because many infected baby teeth — particularly those with moderate decay and pulp exposure from a cavity — have infection limited to the crown portion of the pulp. Removing only the diseased coronal pulp, rather than the entire pulp including the roots, preserves more tooth structure, is quicker to perform, causes less disruption to the surrounding tissues, and is less demanding on a child's ability to cooperate in the dental chair. When the root pulp is still viable, a pulpotomy provides an excellent, evidence-based outcome.
A pulpotomy is indicated when a baby tooth has pulp exposure due to caries (cavity reaching the pulp), the exposure is not too large, and there is no clinical or radiographic evidence that infection has spread to the root canals. Clinical criteria for pulpotomy: no spontaneous or night pain, no swelling or abscess, no sinus tract, no pathological mobility, and healthy-looking root canals that bleed normally (controlled within a few minutes) when the coronal pulp is removed. If bleeding is profuse, uncontrolled, or there is pus — a pulpectomy is needed instead.
Coronal Pulp
The pulp tissue inside the crown of the tooth, above the root canal orifices. This is exactly what is removed in a pulpotomy. If the infection is confined to this region, the root pulp below may still be viable and can be preserved.
Root Pulp
Pulp tissue inside the root canals, below the crown. If it remains healthy — assessed by normal, controlled bleeding at the root canal orifices after coronal pulp removal — a pulpotomy can proceed and the root pulp is preserved. Unhealthy root pulp (pus, uncontrolled bleeding, no bleeding) means a pulpectomy is required instead.
MTA (Mineral Trioxide Aggregate)
The preferred modern medicament used at the root canal orifices in a pulpotomy. MTA is biocompatible, promotes pulp healing and even calcified bridge formation, and has the strongest evidence base among current pulpotomy medicaments. It is more expensive than formocresol but associated with better long-term outcomes.
Formocresol
A traditional pulpotomy medicament used for over 50 years. It fixes (devitalises) the remaining root pulp tissue rather than preserving its vitality. Still widely used in India and globally, but being phased out in many countries due to cytotoxicity concerns and the availability of superior alternatives like MTA and ferric sulphate.
Stainless Steel Crown
Placed after pulpotomy to protect the remaining tooth structure. Research consistently shows that pulpotomy teeth restored with SSC have significantly better survival rates than those restored with composite or amalgam — the crown provides a complete seal and protects the weakened tooth from fracture.
Sources
A step-by-step walkthrough of the pulpotomy procedure — and what your child experiences.
⏱ 45–60 minutes for pulpotomy + SSC placement, completed in one visitA periapical X-ray is taken to assess the extent of decay, the size of the pulp chamber, root length, and critically — any signs of infection in the root area such as furcation involvement, periapical changes, or internal or external root resorption. The clinical examination checks for spontaneous pain, abscess, sinus tract, and tooth mobility. If any of these signs are present, a pulpectomy is likely needed instead of a pulpotomy.
A dental X-ray is mandatory before any pulp therapy. Without it, the dentist cannot tell whether the infection is limited to the crown or has spread to the roots — the single most important factor in deciding between pulpotomy and pulpectomy.
Topical anaesthetic gel is applied to the gum before the injection. Local anaesthesia (infiltration or block) is administered. Once the tooth is numb, a rubber dam is placed around the tooth to isolate it from saliva, keep the field dry, and protect the child from swallowing irrigants. Rubber dam use is a standard of care marker for pulp therapy.
If your child is anxious, ask about nitrous oxide sedation before the appointment. It makes the injection and the entire procedure significantly easier for young or nervous children.
An access cavity is prepared through the top of the tooth to expose the pulp chamber. All coronal pulp tissue is removed using a large round bur at low speed or a spoon excavator. The root canal orifices are then assessed: the dentist applies gentle pressure with a cotton pellet and observes the bleeding. Controlled bleeding that stops within 3–5 minutes indicates healthy root pulp — and pulpotomy can proceed. Uncontrolled bleeding, pus, or no bleeding indicates that a pulpectomy is required instead.
This bleeding assessment is the critical decision point. A dentist who does not perform it — or who proceeds with pulpotomy despite uncontrolled bleeding — is likely to produce a failed result that requires retreatment.
Once haemostasis (bleeding control) is confirmed, the chosen medicament is applied to the root canal orifices. MTA is the current evidence-preferred choice: it is packed onto the orifices as a paste, a moist cotton pellet is placed over it, and it is left to set (or a fast-set MTA is used). Ferric sulphate (an astringent that quickly fixes the surface tissue) is a faster alternative. Formocresol is applied as a diluted solution on a cotton pellet placed at the orifices for 5 minutes. The choice depends on the dentist's training, clinic protocol, and material availability.
If you have a preference for MTA over formocresol — due to the cytotoxicity concerns around formocresol — it is entirely reasonable to ask your pediatric dentist which medicament they use and why.
After medicament placement, a base of zinc oxide-eugenol or glass ionomer cement is placed over the orifices. The tooth is then prepared for a stainless steel crown: sides are trimmed slightly, the correct SSC size is selected, crimped to fit the gingival margin, and cemented with glass ionomer cement. The child bites firmly to seat the crown fully. Excess cement is cleaned. The entire appointment — pulpotomy and SSC — is completed in a single visit.
A stainless steel crown is strongly recommended after pulpotomy. Studies consistently show that pulpotomy teeth with SSC last significantly longer than those restored with composite or amalgam. The crown is not an upsell — it is the correct restoration.
Stainless steel crown adds ₹800–₹2,000. Total treatment cost is usually ₹2,300–₹6,000 per tooth. Pulpotomy is consistently less expensive than pulpectomy due to its shorter duration and simpler technique.
Based on Capcane's 2026 review of pediatric dental clinic pricing across Bangalore.
How much does a pulpotomy cost in Bangalore? Front teeth (incisors) have a single root and are simpler; molars have multiple roots and the procedure is somewhat more involved, though still less so than a full pulpectomy.
| Tooth type | Procedure | SSC | Total |
|---|---|---|---|
| Front tooth (incisor) | ₹1,500–₹2,000 | ₹800–₹1,200 | ₹2,300–₹3,200 |
| Premolar | ₹1,800–₹2,800 | ₹1,000–₹1,500 | ₹2,800–₹4,300 |
| Molar (most common) | ₹2,500–₹4,000 | ₹1,200–₹2,000 | ₹3,700–₹6,000 |
Medicament choice
MTA-based pulpotomy costs slightly more than formocresol-based pulpotomy because MTA itself is a more expensive material. However, MTA has better long-term evidence and fewer concerns around cytotoxicity. The difference in procedure cost is typically ₹300–₹600.
Dentist qualification
An MDS Pediatric Dentist charges more than a general dentist. For straightforward pulpotomy in cooperative children, a well-trained general dentist can deliver a good outcome. For young or anxious children, complex cases, or when behaviour management is needed, an MDS Pediatric Dentist is preferable.
Stainless steel crown
Always confirm whether the SSC is included in the quoted price or charged separately. The SSC is essential and should not be skipped. Without it, the pulpotomy tooth is significantly more likely to fail through fracture or microleakage.
Clinic type
Specialty pediatric dental clinics in metro cities charge ₹3,500–₹6,000 for pulpotomy + SSC. General dental practices charge ₹2,300–₹4,500. Government dental hospitals with Pedodontics departments offer subsidised rates.
Red flags — watch out for these
Pulpotomy is an excellent procedure when the right case is selected and it is performed with good technique. The critical issue is case selection: choosing pulpotomy when infection has already reached the root canals leads to failure. The three things parents most commonly get wrong are: not insisting on an X-ray before the procedure, not understanding the difference between pulpotomy and pulpectomy, and assuming formocresol vs MTA doesn't matter.
Signs you genuinely need it
Signs you might not need it
Capcane's position
Share your child's X-ray and the dentist's recommendation with us. We will review whether pulpotomy is appropriately indicated based on the clinical signs and radiographic findings, and flag if a pulpectomy is more likely to succeed.
Second opinion on pulpotomy vs pulpectomy
Share your child's dental X-ray and the dentist's recommendation. An MDS Pediatric Dentist reviews the radiographic findings, assesses whether the signs support pulpotomy or pulpectomy, and gives you an honest recommendation. We flag when a pulpotomy is being recommended despite visible root-level infection — or when a pulpectomy is being recommended unnecessarily for a tooth that would respond to the simpler procedure.
Clinic vetting for child-friendly protocols
We evaluate pediatric dental clinics on the criteria that matter for pulpotomy: use of rubber dam, availability of MTA or ferric sulphate (not solely reliant on formocresol), MDS qualification, behaviour management capability, and planned follow-up. We do not refer based on proximity or promotional pricing alone.
Transparent cost comparison
We provide a realistic cost range for pulpotomy + SSC in your city, broken down by tooth type and clinic category. We flag when a quote is significantly over or under the typical range, and help you understand what is usually included vs separately charged so you are not surprised at the end of the appointment.
Real outcomes from real patients.
Anitha S.
“My daughter had severe pain from a decayed molar and I was expecting them to just pull it out. Capcane helped me understand that pulpotomy was an option since the infection hadn't spread to the roots. We found a pediatric dentist near us — the whole thing was done in one appointment, my daughter was very calm with the laughing gas, and she had no pain afterwards. The silver crown looks fine and she's eating normally. So glad we didn't just go for extraction.”
Rajan P.
“One dentist told us our son needed a full root canal (pulpectomy). We weren't sure and reached out to Capcane. They reviewed the X-ray and said the root pulp looked fine and a pulpotomy should be tried first — which is less invasive and less expensive. The pediatric dentist they referred us to agreed, performed the pulpotomy with MTA, placed the SSC, and it's been 5 months with no issues. We saved about ₹2,500 and avoided a more invasive procedure.”
Get a free, honest second opinion — no commitment, no hidden fees.