What Are The Types of Pulp Cap Treatment?
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.
Direct Pulp Caps
Your dental professional will perform direct pulp capping when the healthy pulp becomes completely exposed. This procedure involves:
- Removing decay. The dental professional will drill the cavity and remove any decayed tooth material. They will then thoroughly clean the site.
- Adding sedative material. Once all the decay is removed, the dental professional will use a sedative material to protect the pulp from bacteria until the dentin can repair itself.
- Filling the cavity. Finally, a temporary or permanent filling is placed to strengthen the tooth and allow the patient to chew and bite normally.
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 Caps
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:
- Removing decay. The dental professional will remove most decayed tooth material but leaves a small portion to cover the pulp tissue.
- Adding sedative material. Like direct pulp capping, a protective layer of sedative material is applied to the decayed dentin to promote remineralization.
- Filling the cavity. Next, the dental professional will place a temporary filling until you return for your second appointment.
- Evaluating the progress. Six to eight months later, the dental professional will remove the temporary filling to evaluate the healing. In many cases, the previously decayed dentin has regenerated, and any residual decay is removed.
- Providing permanent restoration. Finally, a permanent filling is placed to strengthen the tooth and allow the patient to chew and bite normally.
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.