Direct Pulp Capping - Possible Alternative to Root Canal

If your dentist is suggesting a root canal and you would rather do everything you can to save the tooth, including its root and nerve, direct pulp capping may be an alternative to the traditional and controversial root canal.

The challenge is to find a dentist who has experience with this procedure.

What is pulp capping?

The dentist drills out the decay of a tooth, and then places a cap over the exposed pulp. The tooth can then, hopefully, form dentin over the pulp.

Pulp capping requires the tooth to be still alive. To test this, the dentist ...

... may perform an electric vitality test, where the dentist must gauge your reaction to different stimuli to the tooth.

... perform a visual inspection of the tooth and surrounding gums. The tooth should have its natural color and not be darkened. Surrounding gum tissue should be pink and not inflamed. There should be no puss pockets in the gum near the bone of the tooth (which may indicate infection or abscess). The dentist may even look at a (hopefully DIGITAL) x-ray to look for infection in the bone surrounding the tooth.

This procedure may be an excellent option ...

... in cases where the nerve has been exposed very recently due to a trauma to the tooth; thus has only been irritated for a short period of time.

... if there is only a minimal exposure of the pulp, such as 1 to 2 millimeters. The nerve may not have suffered as much damage then, and the cap doesn't have as much surface to cover.

How is it performed ...

The dentist will remove the cavity exposing a small amount of the pulp. Medication is placed the pulp, and then the pulp cap is placed. This is followed by a filling.

The dentist may do a temporary filling and check in six months or so whether dentin has formed over the pulp.

In cases where pulp capping is not an option, non-reactive metal implants made from zirconium can be considered.

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