Immediately following the pulpectomy, there may be numbness in the lips, mouth, tongue or jaw for one or two hours after the procedure. This is normal. The patient may want to avoid chewing during this time. As the anesthetic wears off, there may be a tingling sensation in the mouth and jaw. Antibiotics may be prescribed if there is evidence of infection extending beyond the root.

The dentist may advise the patient to avoid chewing or biting with the treated tooth since the temporary filling is not as strong as the permanent filling. Sometimes a thin layer of the temporary filling can wear off. If the entire filling dislodges or comes out, the patient is urged to call the dentist or endodontist.

There can be discomfort (pain, soreness or inflammation) for a few days after the procedure. The dentist may recommend over-the-counter pain relievers and/or anti-inflammatory agents or prescribe stronger analgesics (pain medications).

Patients should follow the post-operative care instructions provided by the dentist, including directions for brushing and flossing the affected tooth or special mouth rinses. If pain or inflammation continues or worsens beyond a few days, it could be a sign of infection or other complication. If this happens, the patient is urged to call the dentist or endodontist.

The patient may be asked to wait a week or more to allow the tissues to heal from the pulpectomy and then return for the permanent filling and restoration. These may be completed in one or multiple visits. While an endodontist that performed the root canal treatment may also fill and seal the tooth, patients typically return to a general dentist for restoration of the crown – the portion of the tooth visible above the gum line.

Anesthesia options for all restoration visits, the use of prophylactic antibiotics and other factors are usually addressed as part of the overall root canal treatment plan determined prior to the pulpectomy (see Before the treatment). However, questions or concerns can be readdressed prior to each stage of the restoration.

First, the temporary filing is removed and the pulp chamber and root canal are filled with a permanent material (gutta percha). Adhesive and cement are also placed into the canal to help seal it. A metal or plastic post may be placed into the canal to support the tooth, which may have little of its original structure. In most cases, the tooth will require an artificial crown, especially for teeth used for chewing, such as the molars.

The dentist may recommend patients avoid chewing or biting on the tooth until the final crown has been completed. This will reduce the risk of infection, cracking or fracturing the tooth. Even after the crown is restored, it may be necessary to avoid chewing hard foods (e.g., nuts or hard candy) with the tooth to lessen the chance of damaging the artificial crown.

There may be follow-up exams with the dentist or endodontist to check progress of healing. The patient may be advised to follow good oral hygiene (brushing and flossing daily) and get twice yearly dental checkups.