If decay has not reached the tooth's pulp, your dentist may recommend pulp cap treatment. When plaque biofilm accumulates in the mouth, it first attacks the tooth's hard outer layer (enamel). The enamel covers the softer, bulky material called dentin. Inside the dentin lies the pulp — a soft, non-calcified tissue consisting of blood vessels, nerves, and connective tissue. When decay reaches the pulp, it can cause severe pain and require a root canal or tooth extraction to treat.
In certain situations, the healthy pulp can become exposed from decay or trauma. If the pulp shows no signs of infection, your dental professional can use a pulp cap treatment to restore the tooth.
Two types of pulp cap treatment exist, depending on the tooth type and level of decay. Your dental professional may not know the best treatment option until all the decay is removed. Many patients prefer pulp capping because it's less invasive and costly than a root canal. However, you still root canal might be needed even after the pulp cap procedure is completed.
Your dental professional will perform direct pulp capping when the healthy pulp becomes completely exposed. This procedure involves:
Direct pulp capping occurs only on permanent teeth when the pulp becomes exposed. The American Academy of Pediatric Dentistry (AAPD) recommends using a direct pulp cap only on a primary tooth when exposure results from mechanical trauma. If exposure results from decay removal, indirect pulp capping, or a pulpotomy — the partial removal of pulp — is performed instead.
Indirect pulp capping occurs when the pulp tissue is close to the surface but not completely exposed. It usually includes two treatments spaced six to eight months apart. The indirect pulp capping procedure involves:
Typically, your dental professional will recommend indirect pulp capping when you experience no pain, but decay has penetrated the dentin so deeply that removal will expose the pulp. The AADP also recommends indirect pulp capping on almost all primary teeth and young permanent teeth.
Sedative, or temporary, fillings are commonly used in extensive restoration procedures that require multiple sessions or during pulp capping. The name "sedative filling" comes from its ability to soothe a tooth nerve aggravated by decay. Unlike traditional fillings, the materials used in sedative fillings contain natural properties that aid in the dentin repair process. Each material used in sedative fillings provides certain benefits, and common materials include:
Each material provides both advantages and disadvantages, so your dental professional will select the best option for you.
Though pulp capping can help prevent the more invasive and costly root canal, you want to do whatever you can to avoid tooth decay. Start with creating and following a good dental care routine:
By maintaining proper oral hygiene, pulp capping can remain something you only read about. Still, it's reassuring to know that if you need it, a pulp cap treatment might help keep your tooth's pulp alive and well.
Oral Care Center articles are reviewed by an oral health medical professional. This information is for educational purposes only. This content is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your dentist, physician or other qualified healthcare provider.
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