Pulp Capping

When you hear the word "endondontics," you probably think of a root canal. But endodontic treatment entails treating any disease of the tooth's pulp, and endodontists practice several techniques to save teeth. One such example is pulp capping, which is used to keep tooth decay from attacking the tooth's pulp chamber.

Pulp capping offers an alternative to root canal treatments. When large cavities reach the tooth's pulp, you will usually experience a toothache. It's an obvious signal that you need to see a dentist -- and soon, as at-home toothache remedies will only provide you with limited relief, if any at all!

If the pulp becomes infected and the tooth dies, a root canal will be needed to save it from a tooth extraction. But if the tooth's nerve is still alive, pulp capping can be used to restrict the tooth decay from infiltrating the pulp chamber. Sometimes pulp capping is used as a preventive measure to keep a large tooth filling from getting too close to the nerve.

There are several reasons why you and your dentist might choose pulp capping over a root canal:
Saves the nerve and preserves the tooth
Less invasive than a root canal or extraction
Less recovery and sensitivity following the procedure
Costs less than a root canal
A dental filling is often used instead of a dental crown to restore the tooth

Taking Direction
The procedure for pulp capping requires several steps. First, the dental cavity is drilled until the dentist reaches the pulp. Then, the dentist will clean the area and cover the pulp with medicine to protect it from becoming infected.

Once the pulp is capped, the dentist will place a temporary or permanent dental filling in the tooth. If it works, dentin should regenerate over the pulp cap. The procedure usually requires a follow-up visit after several weeks to see if the dentin is developing correctly.

There are two types of pulp capping: direct and indirect. Direct pulp capping is used when the pulp is exposed after drilling. In some cases, the dentist may not need to expose the pulp, and will cap the soft layer of dentin that covers the pulp chamber. This is known as indirect pulp capping.

Proceed Cautiously
There is a very small window in which pulp capping can be performed. In order for pulp capping to be successful, there are a few aspects your dentist needs to take into consideration:

The nerve has to have been exposed recently
There should be minimal, if any, exposure of the pulp
The nerve needs to be alive -- pulp capping will not work on a dead tooth
There cannot be any signs of infection or dental abscess
Whether or not a dentist can perform a pulp cap depends on whether the patient is a qualified candidate for this dental treatment. Your dentist may need to administer some tests to determine if the tooth is healthy enough to withstand pulp capping. As you can guess, pulp capping is much less common than root canals, given all the restrictions surrounding this procedure.

To Cap or Not to Cap
Some may choose pulp capping because they fear the idea of a root canal. But modern root canals are not painful. Although the success rate of pulp capping varies according to the situation, it is much lower than that of root canals. If a pulp cap fails, as approximately 40 percent of them do, the tooth will require a root canal or extraction. This won't just end up costing you more financially, but it will lead to even more time in the dental chair.

Of course, whether pulp capping is an option for tooth repair is determined on a case-by-case basis. Treatment will depend on the patient's age and health status, the amount of damage to the tooth, and what type of pulp cap is needed. For example, direct pulp capping may not be recommended for young children due to a low success rate in baby teeth.