Deep dental decay and trauma can cause bacteria levels to increase very close to the most sensitive part of your tooth – the pulp. This contains blood vessels, connective tissue and nerves which are needed to keep your tooth alive. If dentists expose or almost expose the pulp while removing cavities they must decide whether to carry out a full root canal or try to save the live tissue.

Pulp capping is a key restoration technique that protects a damaged tooth nerve. Dentists apply specific materials directly onto or close to the exposed pulp to help encourage natural healing and new dentine growth. Learning about how pulp capping works will show you how dentists can now save natural teeth.

What Is the Structure of a Healthy Tooth?

To understand what pulp capping is you need to know what the structure of a healthy human tooth looks like. Inside a tooth there is a hard outer layer called enamel.

  • Enamel – Protects the inside of the tooth with a hard outer shell.
  • Dentine – Contains thousands of tiny tubes that send a signal to the nerve.
  • Pulp – Provides nourishment to the tooth and sends pain signals if the tooth gets damaged.

Aggressive bacteria from deep cavities can cause the enamel and dentine to erode leaving direct access to the pulp.

What Is Pulp Capping?

Pulp Capping is a minimally invasive endodontic and restoration treatment that helps to keep the damaged pulp alive. This treatment can be carried out by dentists to help prevent removal of the entire nerve if the pulp is healthy.

  • The dentist will apply a specific material onto the thin dentine or minor nerve exposure.
  • This will help prevent any remaining bacteria in the mouth entering the area.
  • Bio active materials will encourage special cells to create a new protective layer of dentine.
  • Keeping the pulp alive will keep the tooth flexible and strong helping it cope with everyday chewing forces much better than if the tooth was dead.

What Are the Types of Pulp Capping?

There are 2 types of pulp capping.

What Is Indirect Pulp Capping?

  • Indirect Pulp Capping – This is completed if there is deep decay close to the pulp but nothing has penetrated the nerve.
  • During this treatment the dentist will leave a very thin layer of damaged dentine over the pulp.

What Is Direct Pulp Capping?

  • Direct Pulp Capping – This is completed if there is a very small hole exposing clean and healthy pulp.
  • The dentist will apply the material directly onto the bleeding nerve to help stop the minimal bleeding.

What Materials Are Used for Pulp Capping?

Modern dentistry uses advanced bio active materials. These interact with live human tissue to encourage quick healing and new bone like deposition.

  • Mineral Trioxide Aggregate (MTA) – Considered a gold standard material due to its ability to create a tight seal preventing bacteria and being highly bio compatible with live nerves.
  • Calcium Silicates (Bio Ceramics) – These synthetic materials set quickly and are resistant to moisture. They release calcium ions which encourage quick dentine repair without causing discoloration.
  • Calcium Hydroxide – This has been used by dentists for many years due to its high alkaline nature. It helps to neutralize harmful acids and kill any remaining bacteria.
  • Glass Ionomers – The dentist often apply a glass ionomer liner onto the pulp capping materials. This provides a strong foundation and releases fluoride into the dentine.

What Are the Requirements for Successful Pulp Capping?

Not all deep cavities and damaged teeth are suitable for pulp capping. Dentists will assess symptoms and x-rays to ensure a high success rate.

  • Reversible Pulpitis – The tooth should show signs of being reversible. Any sensitivity caused by temperature will quickly disappear.
  • No Pain – There should be no pain at night, throbbing or pain when tapping on the tooth.
  • Live Bleeding – During direct pulp capping the dentist should see bright red bleeding from the nerve.
  • Sterile Conditions – The dentist should work in extremely sterile conditions with a rubber dam in place.

How Does the Pulp Capping Treatment Work?

Learning what happens during a pulp capping treatment will help reduce any anxiety.

  • Rubber Dam – The dentist will place a flexible rubber dam around the tooth.
  • Remove Decay – The dentist will remove the infected enamel and soft dentine.
  • Clean & Dry – The dentist will clean the bottom of the cavity with gentle antiseptic solutions. They will then gently press to stop any minimal bleeding from the nerve.
  • Apply Material – The dentist will apply a thin layer of material such as MTA or Calcium Silicates.
  • Seal Cavity – A strong composite filling will be applied to seal the cavity. Alternatively a protective porcelain crown will be placed.

How Does Pulp Capping Compare to Root Canals?

Many patients want to know how pulp capping compares to a traditional root canal.

  • Pulp capping keeps the nerve alive whereas a root canal removes all the pulp.
  • Pulp capping is a simple one visit treatment during your cavity filling. Root canals require significant shaping and sealing.
  • Teeth that have had a successful pulp capping will remain moist and flexible whereas root canaled teeth are much more brittle.
  • Pulp capping is much cheaper than root canals and crowns.

What Are the Key Takeaways About Pulp Capping?

  • Pulp capping is the best option if you have caught deep cavities early and would like to preserve live nerves.
  • If you have mild sensitivity to hot or cold foods visit your dentist.
  • Have regular check ups every 6 months so your dentist can spot any deep decay before it affects your nerve.
  • Brush and floss your teeth daily to stop bacteria breaking down the enamel.
  • Wear a night guard to protect your teeth from severe grinding and clenching.

What Are the Frequently Asked Questions About Pulp Capping?

Does Pulp Capping Hurt?

No pulp capping is completely pain free. The dentist will apply an effective local anesthetic to numb your tooth, gums and surrounding jaw. You may experience some sensitivity for a few days after the anesthetic has worn off. This can easily be treated with over the counter painkillers.

How Long Will My Pulp Capping Last?

A successful pulp cap can last for many years or even a lifetime. The material encourages your body to produce a permanent wall of new dentine over the nerve in a matter of months. As long as your permanent filling or crown remains undamaged and there is no new decay the nerve will remain protected.

What If My Pulp Capping Fails?

If the pulp capping fails bacteria will enter the area causing irreversible pulpitis or nerve damage. You will experience constant throbbing pain or sensitivity. If this happens your dentist will simply move onto carrying out a root canal.

Can Adults Have Pulp Capping?

Yes adults can have pulp capping. Although young teeth have large pulp chambers and more blood supply, modern bio ceramics mean dentists can still achieve a high success rate with adults showing healthy and non-infected nerve.

Pulp capping is a proven biological treatment to help save natural teeth that have suffered from deep decay or trauma. The material stops damaging bacteria entering and encourages new protective dentine to grow. This vital restoration technique helps to save the live nerve and means root canals may not be needed. If you have any tooth pain visit your dentist for a thorough assessment.