Emergency dental treatments
Pulpectomy: the first stage of a root canal that stops the pain
A pulpectomy takes the inflamed nerve out of a tooth in a single emergency visit. The pain stops; the tooth is dressed and sealed, and the root canal is completed later.
Clinically reviewed by Dr Ibraheem Ijaz, Principal Dentist · GDC 301711 · Last reviewed April 2026
What a pulpectomy is and how it differs from a full root canal
The pulp is the living tissue inside a tooth: nerve, blood vessels and connective tissue running from the crown down through each root. A pulpectomy removes all of it, from the chamber under the enamel to the tip of each root. The name comes from the same Greek root as appendectomy: taking the pulp out. Its cousin, the pulpotomy, removes only the part in the crown and is mostly used on children’s teeth and, occasionally, as a very short-term emergency measure in adults.
A full root canal does three things: removes the pulp, shapes and disinfects the canals, and fills them permanently. A pulpectomy is the first of those three, done as a stand-alone emergency stage. Because it is the removal of the nerve that stops the pain, a pulpectomy gives most of the relief of a root canal on the day you walk in, and leaves the finer, slower work for a planned visit. If you want the whole treatment described end to end, read the emergency root canal page; this page is about that first stage.
When we choose a pulpectomy over extraction or a filling
Three conditions have to be met. First, the nerve must be beyond saving: pain that lingers after hot or cold, pain that comes on by itself, pain that wakes you. A nerve that is merely irritated does better with a temporary filling and time. Second, the tooth must be worth keeping: enough sound structure above the gum to restore, no crack running down the root, and roots that can be cleaned. Third, you have to want to keep it, having heard the fees for both routes.
The pulpectomy comes into its own in the emergency slot because it is the fastest way to turn a tooth from unbearable to quiet. A complete root canal on a molar can take over an hour and is better done when the tissues are calm. A pulpectomy on the same tooth takes around 30 to 45 minutes, which fits the day, and the tooth is far easier to treat properly at the second visit.
We do not choose it when the tooth is broken below the gum, when the X-ray shows a fractured root, or when gum disease has loosened the tooth so much that saving the nerve is pointless. In those cases we recommend an emergency extraction instead.
What happens during a pulpectomy at Deepcar
Confirming the diagnosis.
Getting you numb.
Isolating the tooth.
Opening the tooth.
Removing the pulp.
Dressing and sealing.
Pulpectomy fees and what comes next
The pulpectomy fee counts towards the complete root canal, so you do not pay for the first stage twice. The exact figure depends on the tooth and is given to you in writing before we begin. Fees for every emergency treatment are listed on the emergency fees page.
| Treatment | Fee (from) |
|---|---|
| Emergency examination including X-rays | £30 |
| Pulpectomy (emergency root canal, stage one) | from £200 |
| Completion of root canal at the second visit | Balance of the complete root canal fee, from £450 in total |
| Crown to protect a back tooth afterwards | £750–£1,000 |
| Out-of-hours (after 6pm weekdays, weekends) | Additional charge |
Aftercare for the days after a pulpectomy
First 24 hours. Wait for the numbness to go before eating. The ligament around the root has been inflamed for days and will feel bruised for two or three more; take ibuprofen and paracetamol as directed on the packet, starting before the anaesthetic wears off. Chew on the other side. No smoking, which slows the healing at the root tip.
The first week. Biting tenderness fades day by day. The temporary filling is solid but not indestructible, so keep hard and sticky foods away from it. Brush and floss as normal. Call us if the pain climbs instead of falling after two days, if the tooth becomes tender to touch again after settling, if the temporary comes out, or if the gum or face swells. A flare-up between visits happens in a small number of cases and is treated by reopening the tooth and changing the dressing.
Why the tooth is not fixed yet
A dressed tooth feels normal, which is the danger. The temporary seal is designed to last weeks, not months. Left longer, saliva creeps under it, bacteria recolonise the empty canals and an abscess forms at the root tip, sometimes without pain until it is large. At that point the tooth may need a longer and less predictable treatment, or may be lost.
We book the second visit, usually one to three weeks later, before you leave. At that appointment the canals are shaped, disinfected again and filled with gutta-percha, and a permanent filling or a crown is planned. Nik, who treats root canals under the dental microscope, carries out most of these completions; the full course is described on our root canal treatment page.
Questions, answered
Common questions
Is a pulpectomy the same as a root canal?
It is the first stage of one. A pulpectomy removes the nerve and dresses the tooth; a root canal goes on to shape, disinfect and permanently fill the canals. You need both to keep the tooth long term.
Does a pulpectomy hurt?
Not during treatment, which is done under local anaesthetic. The tooth feels bruised for a few days afterwards, which ordinary painkillers control.
How quickly does the pain stop?
The throbbing usually stops as soon as the tooth is opened and the pressure inside is released. Tenderness to biting takes a few days to settle.
Do I need antibiotics as well?
Usually not. Removing the infected pulp deals with the source. Antibiotics are only added if infection has spread into the face or you have a fever. See our page on antibiotics for dental infection.
How long can I leave it before the second visit?
Ideally one to three weeks. The dressing keeps working for around a month, but the temporary seal starts to leak after that and the tooth can become reinfected.
Can a pulpectomy be done on a baby tooth?
Yes, it is one of the ways of keeping an infected baby molar until it is ready to fall out naturally. The materials used are different because they need to dissolve along with the root.
In pain? Don’t wait
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334 Manchester Road, Deepcar, Sheffield S36 2RH · Free parking