Signs a milk tooth may need nerve treatment
- toothache, especially at night or when eating
- swelling or a pimple on the gum near the tooth
- a large, dark cavity
- a tooth that has turned grey after a knock
- your child avoiding chewing on one side
What happens
- Examination and X-ray to check how far the decay has gone and whether the tooth can be saved.
- Numbing with a gel first, then local anaesthetic. We explain everything in simple words and agree a stop signal with your child.
- Treating the nerve. In a pulpotomy, the inflamed top part of the nerve is removed and a medicated material placed. In a pulpectomy, the whole nerve is removed and the canals filled with a material that dissolves naturally.
- Protecting the tooth. A filling, and usually a preformed crown on back teeth, often at the same visit.
Aftercare
- Wait until the numbness has worn off before eating, so your child doesn’t bite their lip or cheek.
- Soft food for the rest of the day.
- A children’s painkiller suitable for their age if they’re sore, following the pack.
- Brush the crown like any other tooth.
- Call us if there’s swelling, fever, or pain after two or three days.
When saving isn’t possible
If the tooth is too broken down, the infection has spread too far, or the adult tooth is nearly through, extraction is kinder. If it’s a back tooth lost early, a small space maintainer can keep room for the adult tooth.
At Petal Smiles
Our paediatric dentist sees children who need specialist care, including nerve treatment in milk teeth, and our paediatrician, Dr. Sunisha Arora, is at the same clinic. We’re open 10am to 8pm every day and see children in pain the same day. You get the fee after the examination, before treatment starts. See children’s dental care.
Questions patients ask us
Why not just remove the milk tooth?
Milk molars hold space for adult teeth until about age 10 to 12. Removing one early can let neighbouring teeth drift, causing crowding, and may need a space maintainer. Saving it is often simpler for the child in the long run.
What is the difference between a pulpotomy and a pulpectomy?
A pulpotomy removes the inflamed top part of the nerve and keeps the healthy roots. A pulpectomy removes all of the nerve, cleans the canals and fills them with a material that dissolves as the adult tooth comes through.
Is root canal treatment painful for children?
The tooth is numbed, so it shouldn't hurt. We explain each step in child-friendly words and go at your child's pace. Some tenderness for a day or two afterwards is normal.
Does my child need a crown afterwards?
Usually, on back teeth. Treated milk molars become brittle, and a preformed crown protects the tooth until it falls out.
What happens if a decayed milk tooth isn't treated?
The infection can cause pain and swelling, and in some cases can affect the adult tooth developing underneath.
Sources
ADA MouthHealthy: baby teeth ↗American Academy of Pediatric Dentistry: parent FAQs ↗NHS: tooth decay ↗Last updated 14 October 2026. This page explains options in general terms; your own plan comes from an examination.