Symptoms the images can’t show
An X-ray can’t record that a tooth woke your child at three in the morning. Tell us when pain began, whether it appears without eating, how often it disrupts sleep, and which medicines you have tried.

Much of the decision about a baby tooth’s canals is made by looking at its roots on an X-ray. For families in Puslinch, we explain what the images can show, how root condition affects whether a pulpectomy is suitable, and what the alternatives look like.
A cavity is visible in the mouth, but the roots are not. On an image, the dentist can see how long the roots of a primary tooth still are, whether the bone around them looks affected, and where the permanent tooth is developing. Those details help decide whether a pulpectomy is reasonable. In that procedure, pulp that is irreversibly inflamed or has died is removed from the crown and canals, the spaces are cleaned, and a filling material appropriate for baby teeth is placed.
The images also help separate this from a pulpotomy, which suits teeth whose root pulp is still healthy and is left in place. And they show why canal treatment in a baby tooth is not an adult root canal made smaller: primary roots shorten naturally as the adult tooth approaches, so materials and follow-up must allow for that change.
Our starting point is still whether this tooth should stay at all. We combine the images with symptoms, the amount of tooth remaining, your child’s health and their other treatment needs. When a pediatric dentist, a different procedure or extraction would be the sounder option, we will show you on the image what led us there.

No single X-ray tells the full story. Your description of symptoms and the clinical examination add context, and a calm appointment day does not outweigh a history of pain or swelling.
An X-ray can’t record that a tooth woke your child at three in the morning. Tell us when pain began, whether it appears without eating, how often it disrupts sleep, and which medicines you have tried.
Mention a bump on the gum, discharge, a sour taste or facial swelling, including episodes that faded. These signs may match changes on the image and need assessment. Please don’t squeeze the area or treat drainage as healing.
When roots have shortened a great deal, or other changes appear, canal treatment may not be sensible. Ask how close the tooth is to natural loss and what the image shows. The cavity alone can’t answer this.
Get prompt dental advice when infection is suspected. Difficulty breathing or swallowing, rapidly spreading facial swelling, or a child who seems seriously unwell requires emergency medical care.
For a primary tooth with favourable findings, pulpectomy aims to manage diseased pulp and help the tooth remain functional until it would normally be shed. Root condition is a central part of selection. Removal should be weighed at the same time, because some teeth are better extracted.
Success is never assured. Ask the dentist to describe this tooth’s prognosis, the limits of treatment and what would happen if symptoms carried on or returned. Seeing the evidence on the image often makes that conversation clearer, and helps you avoid assuming that keeping a tooth is always the better result.
Patient information: AAPD — non-vital pulp therapies in primary teeth
Ask what this tooth adds to chewing and to guiding the teeth developing below in the time it has left. Then consider what treatment asks of your child and whether the restoration and reviews are practical.
Canal treatment does not repair the damaged chewing surface. A suitable final restoration needs to be part of the plan. Ask what will close and protect the tooth, and whether every stage is already scheduled.
Clinical notes and appropriate radiographs give a baseline for spotting change. Ask when the first follow-up is due and how future images will be timed. Your reports of eating, comfort and swelling still matter.
The number and length of visits depend on the tooth and on your child. Talk to us about the comfort measures planned, and whether another setting would be more appropriate.
The clinician combines symptoms, examination, root findings and restorability, then explains the alternatives and the outlook. Ask whether referral to a specialist makes sense, and how unexpected findings during treatment would change things.
Local anaesthetic and isolation are arranged to fit the case. Your child should know how to signal that they need a pause. Share any past difficult visits, health conditions or support needs before the appointment.
The dentist removes affected pulp, cleans the internal spaces with suitable techniques, and fills the canals with a resorbable material chosen for primary teeth. The method depends on the tooth, and it is clinical care only.
The tooth is sealed and restored, which may include a crown, and an image may document the completed canal treatment where indicated. Confirm any remaining visit, the home-care plan and the review timetable before leaving.
Ask what your child may notice after this specific treatment. Every caregiver should know any eating restrictions, medicine advice and remaining appointments.
After local anaesthetic, supervise your child so they don’t chew on their lip, cheek or tongue. Follow the advice about food and drinks. Use only pain medicine appropriate for your child’s age, weight and health, as directed by the treating professional.
When treatment is staged, ask how to look after the temporary filling and when to return. A lost filling, loose crown or new food trap should be reported promptly. Avoid household glue, and don’t postpone the final step because the tooth feels better.
Comfort is encouraging, but only examination and images taken at the right intervals can show how the area around the roots is responding. Attend those reviews, keep helping with home care, and ask about prevention for the rest of the mouth.
Patient information: AAPD — local anaesthesia and pediatric aftercare
If another office took X-rays recently, ask for copies and bring them. They help us explain what was proposed and whether new images are needed.
Talk with our Bronte Street team about your child’s tooth, recent X-rays, or a pulpectomy that has been proposed. We will explain what the images and examination show, the case for keeping or removing the baby tooth, and when referral is appropriate.
Recommendations depend on examination and suitable imaging. Call if swelling is active or pain is increasing.