You just received treatment for the pulp of your tooth (or your child’s tooth). Following these instructions is essential for a successful procedure and comfortable recovery.

Which procedure was performed?

Both procedures treat the dental pulp — the soft internal tissue of the tooth containing nerves and blood vessels. The difference is which part of the pulp was treated and why:

Pulpotomy — Most common in children — Common in children: Only the pulp from the chamber (the upper part of the tooth) is removed. The pulp in the root canals is left intact if healthy. A special medication is placed and the tooth is sealed, usually with a stainless steel or composite crown. When is it done? When decay reached the pulp but only affected the pulp chamber, leaving the canals healthy. Very common in baby teeth with deep decay.
Pulpectomy — Complete root canal treatment — Baby & permanent teeth: All the pulp is removed — both from the chamber and the root canals. The canals are cleaned, disinfected and filled with a biocompatible material. The tooth is sealed and usually covered with a crown. When is it done? When infection or damage affected the entire pulp, including the roots. Performed in both baby teeth and permanent teeth.

In both cases the goal is to save the tooth — avoid extraction while maintaining dental function and space. Treatment success depends greatly on proper aftercare.

Why treat baby teeth if they’ll fall out anyway?

Baby teeth are essential. They hold space for permanent teeth, allow proper chewing, help with correct pronunciation and contribute to bone development. A prematurely lost baby tooth can cause spacing problems in the permanent dentition.

How You Feel Leaving the Clinic

Anesthesia is still active — read this before arriving home

Local anesthesia can last 2 to 4 hours after the procedure, depending on the type and amount used. In young children it may last a bit longer.

Numbness of lip, cheek or tongue (Important): Completely normal. Don’t press or rub the numb area — it can become irritated without you feeling it. In children: actively watch them to prevent them from biting their lip or cheek. This is very common and can cause painful wounds.
Difficulty closing the mouth fully: While anesthesia lasts there may be some difficulty speaking or slightly increased saliva. This is temporary.
Pain as anesthesia wears off (Important): When the anesthesia starts to wear off (2-3 hours after), discomfort may appear. Take the indicated pain reliever BEFORE it disappears completely — it’s much more effective to take it preventively.

⚠️ In young children: Actively supervise while anesthesia is in effect. Children don’t understand the sensation of numbness and may bite their lip, cheek or tongue without realizing it, causing serious wounds.

Post-Treatment Medication

Take medications exactly as instructed

IMPORTANT: Start the pain reliever BEFORE the anesthesia effect disappears completely. Don’t wait for pain — controlling pain from the start is much more effective.

Pain Reliever / Anti-inflammatory — Ibuprofen or Acetaminophen (as indicated by age and weight): Controls post-procedure pain. In children, dosage is always calculated by weight — strictly follow the dentist’s indication. Take with food to protect the stomach. In children: never use aspirin. Always follow the dose indicated by the dentist based on the child’s weight.
Antibiotic — As prescribed: If an antibiotic was prescribed (usually when there was active infection), it is essential to complete the full course even if pain subsides. Stopping early can allow the bacteria to return more resistant. In children: pediatric antibiotics are usually in suspension. Shake the bottle well before each dose and refrigerate as indicated by the manufacturer.

Pain and Discomfort: What to Expect

Knowing the normal progression avoids unnecessary worry

First hours — Discomfort as anesthesia wears off (Normal): As the anesthesia fades, mild to moderate discomfort may appear. This is completely normal — living tissue was treated inside the tooth. Control with the indicated pain reliever.
Day 1-2 — Sensitivity when biting (Normal): Very common to feel sensitivity or mild pain when biting in the treated area. The periodontal ligament (tissue surrounding the root) may be slightly inflamed from the procedure.
Day 3-5 — Progressive improvement (Improving): Discomfort should be clearly decreasing. Bite sensitivity reduces. The child or adult patient starts feeling more normal.
Week 1-2 — Full recovery (Good): In most cases discomfort has disappeared. The tooth functions normally. If there’s any mild and decreasing discomfort remaining, it’s still normal.

If pain is very intense from the start, or if after day 3 pain increases instead of decreasing, contact the clinic. Don’t endure pain that doesn’t respond to the prescribed medications.

Eating After Treatment

What you eat in the first hours and days matters a lot

While anesthesia lasts (first 2-4 hours):

Don’t eat any solid food while lip, cheek or tongue are numb
You can carefully drink cool or warm liquids (use the opposite side)
In children: nothing to eat until they fully recover sensation
The risk of biting the cheek or tongue without feeling it is very real and can cause serious wounds

The first 2-3 days:

Soft and easy-to-chew foods
Always chew on the OPPOSITE side from the treated tooth
Lukewarm or cool temperature — avoid very hot foods that can cause discomfort
Avoid hard, crunchy or very sticky foods
In children: soups, mashed potatoes, yogurt, eggs, soft fruit — foods requiring minimal chewing

Recommended foods

Smooth natural yogurt
Mashed potato or vegetables
Scrambled or boiled eggs
Warm soups and broths
Gelatin and custard
Banana and soft fruits
Ice cream (if no cold sensitivity)
Very well cooked pasta
Soft fish
Avocado

Avoid the first days

Very hard or crunchy foods (chips, crackers, nuts)
Very hot foods (can generate pain)
Hard or chewy candies
Chewing gum (chewing may loosen temporary restoration)
Very fibrous hard-to-chew food
Very cold or very hot drinks if there is sensitivity

Oral Hygiene After Treatment

Keeping the area clean is important — carefully at first

Same day of treatment — Gentle brushing of the rest of the mouth: Brush all your teeth normally except the treated area. In the area of the procedure, wait until the anesthesia has completely worn off. If a temporary crown was placed that same day, avoid brushing it directly for the first few hours.
Following day onward — Resume normal hygiene carefully: Gently brush the area of the treated tooth. You don’t need to avoid it — on the contrary, keeping it clean is important to prevent plaque buildup that could affect the restoration. Use a soft-bristle toothbrush.
Dental floss — Yes, but carefully: Use dental floss in spaces adjacent to the treated tooth with gentle motions. If the tooth has a temporary crown, slide the floss carefully without pulling it up abruptly to avoid dislodging the crown.

In children — special hygiene:

Brush the child’s teeth yourself, don’t let them do it alone the first days
Use an ultra-soft bristle children’s toothbrush
If the child has a steel crown: you can brush it normally, it’s very resistant
Avoid flossing in the crown area the first 2-3 days
If the child complains of pain when brushing that area, brush more gently and let us know

The Crown That Was Placed

Important information about the restoration on the treated tooth

Stainless Steel Crown (Children)

The most common after pulpotomy in baby teeth. Very resistant, doesn’t fracture, perfectly protects the treated tooth and lasts until the baby tooth naturally falls out. Its silver color is completely normal and accepted.

May feel slightly different when biting the first days — normal
Brush it normally, it’s very resistant
If it loosens or falls off, bring it to the clinic — the treated tooth is unprotected without it
Eventually the baby tooth falls out with the crown included — that’s normal

Composite or Temporary Crown (Adults)

In adults, after pulpectomy a temporary crown is usually placed while the permanent crown is fabricated in the laboratory. This temporary crown protects the treated tooth.

Avoid chewing very hard or sticky things in that area
If it falls off or loosens, contact us — the tooth is exposed
Don’t use the tooth with temporary crown to open things
The permanent crown will be placed at the next scheduled appointment

In both cases: if the crown loosens, moves or falls off, contact the clinic as soon as possible. The treated tooth without its crown is vulnerable to fracture and contamination.

Warning Signs

Contact the clinic if you experience any of these symptoms

Contact the clinic if you experience:

Intense pain that doesn’t respond to medication: Very strong pain that isn’t controlled by the prescribed pain reliever may indicate the treatment needs additional evaluation or there is a complication.
Pain that increases after day 3: Discomfort should decrease over time. If after the third day pain worsens instead of improving, let us know.
Fever above 38°C (100.4°F): Especially in children, fever can indicate active infection. In adults it is also an important warning sign requiring attention.
Swelling in the gum or cheek: Swelling that appears or grows days after the procedure may indicate the infection wasn’t completely controlled or an abscess is forming.
Crown falls off or loosens: The treated tooth without its crown is exposed to fracture and contamination. Contact the clinic for replacement.
Fistula or small bump on the gum: A small bump or pimple on the gum near the treated tooth (especially if draining fluid) may indicate persistent infection.
In children: wound on lip or cheek: If the child bit themselves while anesthesia was active, there may be a lesion on the lip or cheek. Let us know so we can evaluate it — in most cases it resolves on its own, but we can guide you.

This is completely normal:

Mild discomfort when biting the first 1-3 days
Sensitivity in the treated tooth the first days
Mild swelling in nearby gum the first days
Mild metallic taste (from sealing materials) — disappears soon
Steel crown feeling different when biting at first
Slight pain when waking if you slept on the side of the treated tooth
In children: being more irritable the day of the procedure — it’s stress

Specific Guide for Parents

What you need to know when the patient is your child

Actively supervise post-anesthesia: Young children don’t understand the sensation of numbness. The main immediate risk is that they bite their lip or cheek without feeling it, causing a considerable wound. Supervise them closely until they fully recover sensation.
Manage fear calmly and positively: If the child is scared or cries after the procedure, validate their feelings without dramatizing. ‘I understand it was uncomfortable, but it’s done now and your teeth are healthier.’ Celebrate their bravery. Avoid saying ‘it won’t hurt anymore’ because it might hurt a little.
Special diet for children: Prepare soft, cool foods the child likes. Moderate ice cream is fine and can be a small treat that improves their mood. Make sure they eat on the untreated side and avoid very hot things.
Physical activity on the day of the procedure: Let the child rest the day of treatment. Bed rest isn’t necessary, but avoid intense physical activity, contact sports or rough play that day and the next.

Can they go to school the next day?

In most cases yes, if the child feels well and pain is controlled with medication. If there is fever, visible swelling or the child is very uncomfortable, it’s better to rest one more day at home.

Follow-up appointment: It is very important to attend the scheduled follow-up appointment. We verify treatment success, the crown status and the surrounding tissue. Don’t cancel this appointment even if the child seems fine.

Next Steps

Treatment doesn’t end today

Recovery (days 1-7): Follow the instructions in this guide. Take prescribed medications, eat on the opposite side and maintain good hygiene.
Control appointment (1-2 weeks): We verify treatment success, check the crown and evaluate tissue response. This appointment is essential — don’t miss it.
Permanent crown if applicable (adults): If a temporary crown was placed, at this or the next appointment the impression is taken to fabricate the permanent crown that will protect the tooth long-term.
Radiographic follow-up (6-12 months): With a periodic X-ray we verify the treated tooth remains healthy and that in children, the permanent tooth is developing correctly beneath.

How do I know if treatment was successful?

No spontaneous pain or pain when biting after the first week
No swelling or fistula on the gum
Crown remains well positioned
In children: tooth falls out at normal age and permanent tooth erupts correctly
On X-ray: tissue around the root looks normal

Key Care Summary

Take pain reliever before anesthesia wears off
Supervise children while numbness lasts
Eat on the opposite side the first days
Gentle hygiene — don’t skip the treated area
Attend the follow-up appointment without fail
Contact us if pain increases after day 3

Frequently Asked Questions

Why does it hurt after if they removed the nerve?

Not all the nerve was removed — in a pulpotomy only the chamber was treated. In a pulpectomy all pulp was treated, but the periodontal ligament (tissue externally surrounding the root) can be inflamed from the procedure and that does generate pain. It is temporary.

How long will the pain last?

Main discomfort usually lasts 1-3 days. Mild sensitivity when biting may persist up to a week. If after a week there is still pain, let us know.

Is it normal for the tooth to be slightly loose after?

Slight initial mobility can occur due to periodontal ligament inflammation. If mobility is noticeable or persists more than a week, let us know for evaluation.

Why did they put a steel crown on my child? Can’t it be tooth-colored?

Stainless steel crown is the gold standard for baby teeth treated with pulpotomy because it lasts longer, doesn’t fracture and seals the tooth better. Composite restorations on pulp-treated baby teeth have higher failure rates. The aesthetics are temporary — the baby tooth will fall out.

What’s the difference between pulpotomy and root canal?

Pulpotomy is technically a partial root canal — only the chamber is treated. Pulpectomy is the complete root canal (chamber + canals). When we talk about ‘root canal’ in adults we generally mean the complete pulpectomy.

Can the treated tooth get infected again?

Yes, though uncommon with a well-performed treatment and a well-maintained crown. If the crown fractures, loosens or there is secondary decay at the edges, it can become recontaminated. That’s why maintaining the crown and having regular check-ups is so important.

Can I give my child over-the-counter pain medication?

Only what we prescribed. Pediatric ibuprofen or acetaminophen are safe at the correct weight-based dose. Never aspirin. Don’t combine medications without consulting us. If pain doesn’t subside with what was prescribed, contact the clinic.

What if my child bit their lip while the anesthesia was active?

It’s quite common and usually looks worse than it is. The typical injury is an ulceration on the lip or cheek that may take 1-2 weeks to heal. Gentle saltwater rinses can help. If the wound is very large, there is heavy bleeding or fever, let us know.

Can pulpotomy be done on permanent teeth?

In specific situations yes, especially in permanent teeth with healthy pulp where decay barely reached it. More common in adolescents with young permanent teeth. In adults with fully developed permanent teeth, complete pulpectomy is generally preferred.

What do I do if the steel crown falls off?

Not an emergency but don’t let it go more than a day or two. The treated tooth is exposed without the crown. Keep the crown if you find it and bring it to the clinic — sometimes the same crown can be re-cemented.

Care After Pulpotomy or Pulpectomy