Dental professionals strive to provide our patients with options that help them avoid costly procedures. There is no treatment that is less expensive than simply using conservative measures to avoid the need for a root canal altogether. The old chestnut “A little prevention is worth a pound of cure” holds true in endodontic treatments as much as anything else in life. While consistent and thorough oral hygiene practices are, without question, the least invasive and most effective form of conservative treatment, sometimes more aggressive treatment is necessary.
The Role of Root Canal Treatments In Preserving Oral Health
While endodontic therapy is an effective and safe form of treatment, the best root canal filling is dental pulp that is healthy and disease-free. Regenerative endodontics is an area of endodontic technology that is still being researched, and while progress is being made, we’re still far from having the ability to regenerate healthy pulp in a predictable way. That being said, there are often other steps that can be taken to address pulpitis than performing a complete root canal treatment.
The first step in preserving healthy pulp is ensuring that a correct diagnosis has been obtained. A thorough diagnosis may explore teeth that are presenting with cavities and determine that the pulpitis the tooth is experiencing is reversible. In the instance that the tooth has no risk factors that are specific to treatment strategies, it can be an excellent candidate for vital pulp therapy. Before this can be done, however, a pulpal and apical diagnosis must be achieved that includes references to your clinical history. A patient evaluation will take place that will involve a radiographic analysis and pulp vitality tests to determine if the pulpitis is a good candidate for vital pulp therapy.
In some cases, a tooth that may otherwise be a viable candidate for this therapy may be ruled out due to other factors. For instance, if the tooth is needed to serve as an abutment for a long-span bridge, a root canal may be done instead. The potential failure of vital pulp therapy has long-standing consequences in this instance than it would otherwise. Root canal therapy will obviously be selected in cases where the tooth is experiencing irreversible pulpitis, but otherwise, vital pulp therapy may be attempted.
Following the assessment of the tooth and the decision that vital pulp therapy is the right choice for this patient’s case, the next step will begin. This step involves the elimination of the existing cavities, and its success is necessary for the vital pulp therapy to continue. Addressing these cavities will include the use of:
- Rubber Dams (To isolate the site)
- High-speed dental drills
- Low-speed dental drills
In the event that high-speed dental drills are used, your dentist will also use a special coolant that will help to protect your teeth from the resultant heat. It also serves to ensure that, while clearing out the decay in your teeth, no bacteria get pushed further into the sensitive inner area of the tooth. Once the cavities have been successfully cleared of decay material, they will be filled with an appropriate restorative material, such as composite resin. If this stage is successful, it will be time to move onto the next stage.
Next Steps Once The Cavities Are Removed
Once these cavities have been removed and a restoration material that is biocompatible (can coexist with living pulp) or is not in contact with the pulp is selected, the next stage can begin. One of the challenges this procedure provides is the need for the material to be biocompatible. For many years there was no such material available, and so a liner would need to be employed that separated the restoration material from the living pulp. Thankfully recent innovations have led to materials that do meet these requirements.
These new materials, known as bioceramics, are not without their drawbacks, however. They have much longer setting times than current restoration materials and may require multiple visits to use successfully. This is why one of the treatment approaches that many endodontists take involves a bioceramic restoration material that requires the use of a dual-core liner.
The specific treatment option that your endodontist will use is based on their preferred treatment approaches and the specifics of the teeth being treated. While the details of the treatment are involved, and the requirements to receive it many, success rates are still high. The processes used have made it possible to save the living pulp of millions of teeth that otherwise would have had to undergo a full root canal treatment.
How To Know If You Can Benefit From Vital Pulp Restoration
The first stage in investigating whether your case is appropriate for the use of a given oral health treatment is seeing your dental professional. In many cases, there is no good way to know whether or not you’ll qualify for vital pulp restoration without undergoing a proper dental exam. During the exam, your cavities will be assessed, and a treatment plan developed. As mentioned above, not everyone can benefit from vital pulp therapy, so a thorough assessment is necessary. Those who can benefit include:
- Those with cavities that have not reached deep into the pulp
- Those with reversible pulpitis
- Young patients with otherwise healthy teeth
- Those with sufficient blood supply to the affected teeth
One important reason that vital pulp restoration is pursued rather than traditional root canal treatments is the efficacy of the treatment. Teeth that have undergone vital pulp restoration successfully show more resilience and longer life-spans than those that have undergone root canal treatments. For this reason, it’s important that you speak to your dentist and endodontist and take the time to determine whether this treatment option is available to you. It will provide your teeth with the best chance of staying with you and serving you faithfully for years to come. Call and schedule your visit to your endodontic specialist today!