Your child is in pain from a decayed or infected tooth, and the dentist recommends performing a “Baby Root Canal” to save the tooth. Root canals have a formidable reputation, but a root canal in children on their primary teeth is not as invasive as a root canal in permanent adult teeth. Root canal therapy for kids, when performed correctly, can be quick and shouldn’t cause pain.

It’s not uncommon for dentists to save a child’s tooth with root canal treatment. Learn everything you need to know about children’s root canal procedures here!

Children’s Root Canal Procedures

A child root canal procedure is when the tooth’s infected or decayed pulp is removed, and the tooth is then cleaned out, treated, and sealed.

Every tooth is connected to the gum and jawbone by roots. The roots are filled with pulp, which is tissue that contains nerves and blood vessels. Sometimes the pulp becomes infected, or the tooth is so decayed that the pulp is exposed and causes your child pain. In these cases, the dentist will perform a root canal. This procedure removes the pulp from the tooth and cleans it out.

When Should Children Get a Root Canal?

Your child’s dentist might recommend performing a root canal on a baby tooth for a few reasons:

  1. There is a deep cavity that is affecting a nerve in the tooth’s pulp.
  2. The tooth’s root is damaged from either an injury or infection.
  3. The tooth is infected, and the decay has reached the tooth’s pulp.
  4. The tooth is causing a lot of pain or sensitivity to different temperatures.

Extraction vs. Root Canal for Kids

Baby teeth will eventually fall out, and some parents question why they would opt to do a child root canal procedure for a baby tooth instead of pulling the tooth. Is it necessary to do a root canal on baby teeth? In most cases, it is preferable to save the baby tooth rather than pull it, and your dentist will do their best to try to save the tooth.

If the permanent tooth won’t be growing in for a while, the missing tooth can interfere with a child’s chewing or speech. We all know that kid with the endearing lisp from a missing tooth, but it’s not always so cute. Teeth serve an essential function in sound pronunciation, and missing the tooth for a prolonged period of time may affect your child’s speech development.

The baby tooth also serves as a placeholder for the future permanent tooth that will grow. If you pull a baby tooth out long before the permanent tooth is due to grow in, it can affect the alignment of the permanent teeth that will grow in, causing your child to need orthodontic treatment later on.

How a Root Canal Is Done

Before the dentist begins the root canal procedure, they may take x-rays to see the tooth’s condition and how far the damage is. The dentist may also discuss antibiotic treatment with you if the tooth is badly infected. If your child has a history of allergies to any antibiotics or anesthesia, it is crucial to let your dentist know.

The dentist will numb the tooth and surrounding area with a local anesthetic so your child shouldn’t feel any pain during the root canal procedure. Some dentists may offer you the option of using nitrous oxide, or laughing gas, that is breathed in via a mask over your child’s nose and can relax them during the procedure.

The dentist will secure a plastic sheet around the tooth to create a sterile environment and prevent your child’s saliva from getting onto the tooth. Saliva can contain bacteria, so it is crucial it doesn’t get into the tooth. The sheet will also prevent your child from swallowing pieces of the tooth or filling while the dentist is working on the tooth.

Once the tooth is numb, the dentist will drill a small hole in the tooth and clean out and remove the pulp. The dentist then treats the tooth with medication to prevent infection and fills it with dental cement. The tooth is then covered with a metal crown to protect the tooth and make it stronger.

Do pediatric dentists do root canals? Your pediatric dentist should be able to perform the child root canal procedure on a baby tooth. Unlike root canals on adult teeth, which an endodontist specialist performs and which requires special equipment, a baby root canal is less invasive, and your pediatric dentist can do it.

Child Root Canal Treatment Methods

When your dentist says your child’s tooth needs a root canal, find out the type of procedure they will need. Depending on how severe the damage to the tooth is, the root canal procedure may be more or less invasive.

Indirect Pulp Treatment

If there isn’t much damage or decay in the tooth’s pulp, it may be possible to just clean out the decay and leave the pulp intact. The dentist will apply an antibiotic and seal up the tooth without removing any of the pulp.


Also known as a partial root canal, a pulpotomy occurs when only the upper part of the tooth’s pulp is damaged. The dentist will remove the affected pulp, leaving the roots intact and alive, clean out the tooth, apply medication to treat and prevent infection, seal the tooth, and then cover it with a metal crown.

A pulpotomy is a relatively common and simple procedure that your child’s regular dentist can perform.


A pulpectomy is needed when the entire tooth’s pulp is infected. The dentist will remove the tooth’s pulp and nerves, treat and medicate the canals, and then fill and seal the tooth. The dentist will then cap the tooth with a metal crown.

A pulpectomy is similar to an adult root canal. However, in a child root canal, the sealant used can dissolve to allow for the permanent teeth to grow in later naturally.

Symptoms You or Your Child May Notice

Does your child need a root canal? Your dentist will be able to determine whether a root canal is necessary, but some warning signs you or your child may notice include:

  1. Tooth Pain – If your child is experiencing intense, sharp pain in their tooth or a steady throbbing ache, see a dentist immediately. It may need a simple cavity filling, or it may need root canal therapy.
  2. Tooth Sensitivity – If your child’s tooth hurts in response to hot or cold foods, it can be a sign of nerve damage that requires a root canal.
  3. An Infection – Signs of an infected tooth include an abscess, a pus-filled pimple on the gums near the tooth’s roots, or swollen, tender gums. Some children may develop fever or swollen lymph nodes from the infection. See your dentist as soon as possible if you suspect an infected tooth, as your dentist might want to start your child on antibiotics.

How to Prepare Your Child for a Root Canal

As with any other medical procedure, explain to your child what will happen and how it will help them feel better. Tell your child that the process will stop the tooth from hurting and make them feel better. It will make their mouth healthier and their tooth stronger.

Your dentist should help prepare your child by showing them their tooth and how they will fix it. Explain that the dentist will numb their tooth so that they won’t feel any pain during the procedure. Many dentists will give the child a signal, such as a raised left hand, to indicate that something is bothering them. This calms children down, knowing that they will be able to have some control during the procedure.

What Happens After a Root Canal

The area around the tooth may be sore for a few days after the root canal, and your dentist may recommend taking a pain relief medication, but your child should not be in any pain. If the tooth was infected, your dentist may prescribe antibiotic medicine to take. Ask your dentist when your child can eat and drink after the procedure and for any special instructions for its care.

Take good care of the crown as you would any other tooth. It is essential to brush and floss the tooth so that it should not become further infected. Once the baby tooth is ready to fall out, the crown will fall out with it. You won’t need any special procedure to remove the crown.

What Are the Risks Involved?

The risks from a child root canal are minimal. Some rare complications that can occur include:

  • Swelling, bruising, or an infection from the cleaning solution if it enters the nearby tissue
  • A dental tool getting stuck in the tooth’s root canal
  • A fistula (tissue opening) between the tooth’s root and the sinuses
  • The seal may not be tight enough or the root not filled completely, which may require another root canal therapy.

In Conclusion

A root canal on a baby tooth is often required to save an infected or decayed baby tooth. The treatment is quite common and is usually not as invasive as a root canal on an adult tooth. Saving the tooth by doing a root canal is most of the time better for your child than pulling the tooth.