How to Avoid Root Canal with Direct Pulp Capping

Do you have a toothache and you're dreading going to the dentist because you fear the drill? Worse yet, do you fear having to get a root canal and crown? If you would rather save the tooth and its vitality (root and nerve), direct pulp capping may be an option for you. This article will explore the use of pulp capping as an alternative to the traditional root canal.

Instructions

Difficulty: Moderately Challenging

How to Understand Pulp Capping

1. Direct pulp capping is a process by which the dentist drills out the decay of a tooth, and then places a cap over the exposed pulp. The tooth can then form dentin over the pulp. When successful, this avoids the tooth having to get a root canal.
2. Direct pulp capping works at its best if the nerve has been exposed very recently due to a trauma to the tooth. In this case, the nerve has only been irritated for a brief period of time.
3. Direct pulp capping also works well 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.
4. In general, pulp capping is done if the tooth is still alive, meaning that the nerve has not died. To test this, the dentist may use one of many tests. One is an electric vitality test, where the dentist must gauge your reaction to different stimuli to the tooth. (I personally don't think this one is all that accurate.)
5. Other ways to test a tooth are to ask questions and look at the tooth. The tooth should have its natural color and not be darkened. Surrounding gum tissue should be pink and not red and swollen. 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 an x-ray to look for infection in the bone surrounding the tooth.

How to Receive Direct Pulp Capping

6. You must first find a dentist trained to do this technique and the belief in using it. This is a challenge. You will find a limited number of dentists who use direct pulp capping in their dental practices.
7. The dentist will look at the tooth and x-rays to determine if your tooth is a candidate.
8. If the dentist and you determine that you will use direct pulp capping, then let the process begin!
9. The dentist will remove the carious dentin (the cavity) and a small amount of pulp will be exposed. A medication is placed over the pulp, and then the pulp cap is placed. This is followed by a filling.
10. The dentist may use a temporary filling. If so, you will come back about 6 months later to make sure dentin has formed over the pulp. Otherwise, the dentist may just do a permanent filling.
11. Happy teeth and happy you! Up to 6 months later, you will return to the dentist to look at the tooth to see if dentin has formed over the pulp, bridging the dentin on each side of the pulpal exposure.

Tips & Warnings

• It may not be easy to find a dentist who will perform the pulp-capping. Many dentists still prefer the traditional method of root canal therapy, followed by an inlay/onlay or crown.
• To find a dentist who does pulp capping, you can go to the World Congess of Minimally Invasive Dentistry to search for dentists, listed in the resources.
• If you feel that the dentist has formed the wrong opinion of your tooth, ask questions. If necessary, seek a second, or even third, opinion.
• Direct pulp capping can help preserve the vitality, or life of the tooth (its nerve). A root canal means cleaning out the root canals, filling them with a substance, and a crown or inlay/onlay. Who wants to have to go through all of that?
• Sometimes, you really have to search to find a dentist willing to try an alternative procedure. The dentist also needs to have the skills to perform the procedure well.