Inside a tooth, under the enamel and dentin, lies the nerve, or pulp. If this delicate nerve dies due to decay or trauma (like getting hit by a baseball or hockey puck) the nerve may become compromised and die. When this happens, a pulpotomy or a pulpectomy may be done to save the remaining tooth structure.
A pulpotomy removes a portion of the diseased nerve from the top (or crown) of the tooth in hopes that the nerve will heal itself without the need for a complete root canal.
A pulpectomy, or root canal therapy, is slightly more involved, requiring the removal of the entire nerve from the both the crown and root(s) of the tooth, followed by the shaping the canals and putting a rubbery material called gutta percha in its place, to not only maintain shape and stability in the root of the tooth, but to also seal the end of the root from bacteria within the mouth.
Both procedures can be done on baby and permanent teeth. The need for one procedure over the other depends on a few factors including the extent of the decay and/or trauma done to the tooth, time available during the visit and the long-term prognosis of the tooth overall.
After the procedure is finished and no symptoms remain, a filling or a stainless-steel crown may be placed to protect the tooth.