AFTER A BABY ROOT CANAL: THE LONGER VERSION
This is the rest of the sheet we texted you. It answers the questions parents ask us most, and it covers the weeks and months after today.
If you are looking for what to do right now, use the sheet we texted you. Everything urgent is on it. If anything on the red flag list is happening, do not read this page. Call us any time on (870) 741-4746. The line reaches Dr. Chad after hours.
FIRST, THE THING PARENTS ASK US ALMOST EVERY TIME
No, you did not cause this.
A cavity gets this deep for a mix of reasons, including how the enamel formed before your child was ever born and how deep the grooves in that tooth are. No parent controls all of that. You brought your child in, and we took care of it.
WHAT WE DID TODAY
A deep cavity reached the nerve inside your child’s tooth. We treated the nerve so the tooth could stay in place. There are two ways we do that. Your child had one of them today, and we told you today which one it was.
Pulpotomy. The nerve was badly inflamed, but the part down in the roots was still alive and healthy. We took out the inflamed top part, left the living part in the roots alone, and sealed it with a cement called MTA.
Pulpectomy. The nerve had died, or it was too inflamed to save. We cleaned the nerve out of the whole tooth, roots included, and filled the space with a soft paste. That paste dissolves on its own as the baby tooth loosens, so it will not get in the way of the permanent tooth coming in underneath.
Either way, we then covered the tooth with a stainless steel crown, which is a silver colored metal cap that covers the whole tooth.
WHY WE DID NOT SEND HOME AN ANTIBIOTIC
This is the question we get most, so here is the plain answer.
The bacteria that caused this were inside the tooth, in a small space that antibiotics reach poorly. Cleaning that space out is what actually treats it. That is what we did today.
An antibiotic is a different tool for a different problem. If your child’s face swells, or a red flag on the sheet we texted you shows up, that is when we need to hear from you, and we may add one then.
HOW WELL THIS WORKS
If your child had a pulpotomy: about 94 out of 100 baby teeth sealed with MTA this way were still healthy 2 years later. With the older medicine dentists used before MTA, it was about 86 out of 100. That is why we use MTA.
If your child had a pulpectomy: we do not have a number like that one to give you. It is a different treatment with a different filling material, so the 94 out of 100 above does not apply to it.
Whichever one your child had, here is the honest shape of it. This treatment works for most children. It does not work for every tooth, and a tooth that is doing fine today can still run into trouble later. A tooth can start to fail on the X-ray before your child feels anything, and the crown hides any color change from us. So we check this tooth on an X-ray at least once a year, and you watch at home for the signs listed on the sheet we texted you.
THE YEARLY X-RAY
A tooth that has had nerve treatment gets checked on an X-ray at least once a year. An X-ray is the only way to see the area under the tooth, where a problem shows up first.
Most of the time this does not mean an extra visit or an extra picture. The regular checkup X-rays we already take usually show us what we need to see. If they do not show that spot under the tooth, we take one small picture of that tooth.
If the tooth does fail, catching it on an X-ray gives us better options than waiting until it hurts. For a baby tooth that has to come out early, that usually means placing a space maintainer so the permanent tooth still has room to come in.
You do not need to schedule this. We track it and we will bring it up at a checkup.
THE SILVER CROWN
Why it is not white. A metal crown covers the whole tooth on every side, and that is what a tooth with a treated nerve needs. A white filling covers less, and a tooth this hollowed out needs the whole thing wrapped.
Why it is staying. Baby teeth fall out. This crown is meant to stay on until that happens, and then it comes out with the tooth.
The gum around it. A new crown can leave the gum looking red or puffy at first. That usually settles down. We will look at it at your next visit.
Flossing around a crown
Keep flossing that tooth. The floss can catch on the edge of the crown, so slide it out to the side when you take it out, instead of snapping it straight back up. If it still catches every time, tell us at the next visit and we will look at that edge.
The spot that matters most is where the crown meets the gum. Brushing right along that line does more for this tooth than anything else you can do at home.
IF THE CROWN COMES OFF
First aid is on the sheet we texted you: keep it, do not glue it back on, bring it in. Put it somewhere it will not get lost, like a small bag or a pill container, and call us.
Here is what happens next. We look at the tooth underneath. Often we can clean the same crown and cement it straight back on at that visit. Sometimes the tooth underneath has changed shape or has a new cavity, and then we fit a new crown instead.
Do not glue it, and do not leave it off. Household glue is not safe in a mouth, and it can trap bacteria against the tooth. A tooth left uncovered can chip, and the teeth next to it can start to drift into the gap.
If it comes off at night or on a weekend and your child is comfortable, it can wait until we open. If your child is in pain, call the after hours number.
SCHOOL, SPORTS AND NORMAL LIFE
School. Most children go back the next day, and many are fine to go back the same day once the numbness is gone and they have eaten something.
Sports, PE and recess. Fine once your child feels up to it. There is nothing about this tooth that needs to be protected from running around. It does not need a mouthguard that it did not need before.
Eating. Normal, once the numbness is gone. The only ongoing rule is the sticky food one: taffy, caramel, chewing gum and similar things pull at the edge of a crown, and that is the most common reason a crown comes off.
If your child also had sedation today, the conscious sedation sheet covers eating, sleeping and activity for the rest of that day. Follow that one for today. Sedation has its own timeline.
ABOUT PAIN MEDICINE
Use the pain medicine card we sent you. If you do not have it, call us. Do not guess at a dose. The card is the only place we print amounts, on purpose, so there is one set of numbers instead of several.
Do not give your child codeine or tramadol, including leftovers from another illness or a prescription belonging to someone else. The FDA says codeine and tramadol should not be given to any child under 12, and should not be given to anyone under 18 after tonsil or adenoid surgery.
Never give aspirin to a child unless a doctor told you to.
Keep all medicine up and out of reach. If your child takes too much, or takes someone else’s, call Poison Control at 1-800-222-1222.
WHEN TO CALL US, ALL IN ONE PLACE
The full list is on the sheet we texted you. The short version:
- Anything on the red flag list, at any time
- Pain that is getting worse instead of better after the first 2 days, or pain that wakes your child at night
- A pimple on the gum near that tooth, even if it does not hurt
- Swelling of the gum or the face
- The crown loose or off
- A bad taste or smell from that area
- The bite feels wrong, or your child says the tooth “hits first”
- Your child will not eat or drink
A baby tooth with a crown getting loose on its own, when it is time for it to fall out, is not a warning sign. Loose plus pain, a gum pimple, or swelling is different. Call us.
Reviewed August 2026