A pulpectomy is a dental procedure in which all of the pulp in the pulp chamber and root canal of a tooth is removed. This procedure is recommended when the pulp has become infected and the infection cannot be resolved. The goal of the procedure is to prevent the infected pulp from spreading an infection which could lead to the loss of one or more teeth.

The pulp is soft living tissue found inside all teeth. This tissue includes cells which generate dentin, the hard material from which teeth are made. When pulp becomes infected, it can cause considerable pain to the patient, and the infection can spread into the jaw and to neighboring teeth, making it a cause for major concern. Infections can often be identified visually, as the tooth or gumline may develop an abscess, and infections can also be seen with an x-ray of the involved tooth.

During the pulpectomy procedure, the patient is given a local anesthetic to minimize pain, although the procedure is usually still uncomfortable. In a pulpectomy, a hole is drilled into the tooth to allow the dentist access to the pulp. The dentist uses tools to carefully remove all of the pulp, and then he or she flushes out the tooth to remove lingering traces of infectious material. Next, the tooth can be filled with an inert substance, and then sealed with a crown or cap. Typically, prophylactic antibiotics are prescribed to reduce the risk of developing an infection in the wake of the procedure.

In a related procedure, a pulpotomy, only the pulp from the crown of the tooth is removed. Pulpotomies are less invasive for the patient, with a shorter healing time and more patient comfort during the procedure. The risk of a pulpotomy, however, is that infected pulp can be missed. Sometimes, a patient may be scheduled for a pulpotomy and it becomes apparent that a pulpectomy is needed, in which case there will need to be a change of plan.

The alternative to a pulpectomy is a tooth extraction, in which the entire tooth is removed. Extractions are usually avoided, if possible, because they can be accompanied with problems. Extracting a tooth can lead to crowding as other teeth move around in the mouth, which can make it problematic for children who have teeth which are still growing. Extractions can also make it difficult to eat, especially if multiple extractions are required.