Exposed Tooth Pulp Can Sometimes Be Treated With a Pulp Cap Instead of a Root Canal

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When you have cavities in your mouth, it is important to treat them because they will only get worse. A simple dental filling can often restore the affected tooth, unless the decay is extensive and you are looking at requiring a root canal to save the tooth. In some cases, you can avoid having a root canal done with a little help from our endodontist by getting a pulp capping treatment.  

Pulp capping is often done when you have a cavity that has not reached your tooth pulp yet. The pulp is the part of your tooth that comprises your tooth nerves, blood vessels and connective tissue. On the outside, the hard tooth enamel protects the softer dentin layer underneath it, which in turn encases the tooth’s pulp. 

 When decay gets to the pulp, you will know it; you will likely feel serious pain until you address it with either a root canal or tooth extraction. The good news is, in some cases, when the tooth decay or trauma leaves the pulp exposed but it is not infected yet, we can restore your tooth by performing a pulp capping treatment. You have options with a pulp capping, as it can be done directly or indirectly. It is generally chosen because it is less invasive and less costly than having a root canal.  

Direct Pulp Capping  

This is done when a perfectly healthy tooth pulp is exposed.  

  1. Our endodontist goes into the cavity and takes out any decayed areas.
  1. We carefully scrub the area and add a sedative material (a temporary filling) to keep bacteria away from the pulp while the dentin layer is healing itself. This material soothes the painful tooth nerves. Sedative fillings have natural properties that help the dentin repair itself: calcium hydroxide (antibacterial and effective repairing the dentin) while mineral trioxide aggregate behaves as a durable sealant with antibacterial properties
  1. Depending on your needs, the cavity is filled with either a temporary or permanent filling material. This ultimately serves to fortify the tooth so you can once again bite and chew with ease.

Note: Your direct pulp capping is done only on permanent teeth. Should the pulp be exposed when the tooth decay is excavated, then an indirect pulp capping (also called a pulpotomy) is done, where only part of the pulp is taken out.  

Indirect Pulp Capping  

This pulp-capping version is done when a tooth’s pulp tissue lies near the surface but is not exposed all the way. This service takes two treatments to complete.  

  1. Our endodontist takes out most of the decaying tissue and leaves just a tiny amount that will cover the pulp tissue.
  1. We add the sedative material to form a protective layer over the decayed dentin so the tooth can remineralize in due time.
  1. We install a temporary filling that will seal the area until you come in for your next appointment (anywhere from six to eight months later).
  1. We then extract your temporary filling so we can assess your healing. We check to see if the previously decayed dentin has properly regenerated so we can take out any leftover decayed material and place a permanent filling. The goal is to ensure your tooth is once again strong and healthy enough to bite and chew properly.

Note: This type of pulp capping is typically done when there is no tooth pain, per se, but tooth decay has penetrated the dentin so that the pulp is exposed. This pulp capping option is done on primary teeth and permanent teeth that are still young.  

Do not Delay Treatment  

Pulp capping can be a viable option if you are looking to avoid getting a root canal but still save a tooth. Do your best to take good care of your teeth and do not ignore the warning signs of tooth decay and cavities. If you are having problems with a tooth, do not delay treatment. Please give us a call to see how we can help!