When dentists examine patients with a damaged tooth that has become infected and abscessed, or filled with tissue-eroding fluid, they typically have two options: Root canal or extraction.
But for patients with less advanced infections that have yet to abscess, there is a third, tooth-saving possibility called direct pulp capping. Much like cleaning and bandaging a wound, the procedure requires the dentist to sterilize the infection, remove all signs of decay, and refill the hole in the tooth to allow the remaining healthy tissue to regenerate. And therein lies a challenge. When dentists fill the tooth, they can never be certain that its natural, highly mineralized dentin matrix will reform during the healing process as a needed buffer between the filling and the pulp tissue inside the tooth. Without an adequate dentin bridge, the direct contact between filling and pulp can irritate the tooth, lead to inflammation, and ultimately additional dental work.