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Tooth Preservation

Vital Pulp Therapy

Keeping a tooth alive when the alternative is a root canal.

When decay reaches close to the nerve, the default answer has often been a root canal. Vital pulp therapy asks a different question first: can we keep the living tooth healthy instead?

The first question is how far into the nerve the bacteria has actually reached. Can we clean the bacteria out, stimulate the tooth to heal and build a dentinal bridge, and keep the tooth alive? Bioactive materials are used to seal and support that healing.

When it's properly diagnosed and treated, clinical and radiographic studies show vital pulp therapy succeeding roughly 81% to 96% of the time. The catch is the diagnosis. A lot of dentists don't take the time to make the right assessment and jump straight to a root canal, but that extra time is worth it. It isn't right for every tooth, and an honest look at what's happening inside comes first.

FAQ

Questions, answered plainly.

Why are root canals non-ideal?

A root canal saves the visible tooth, but it does it by removing the living nerve, which leaves a non-vital (essentially 'dead') tooth behind, and it can't always sterilize every tiny channel inside the tooth. In biologic dentistry there's also the view, rooted in traditional Eastern medicine, that each tooth sits on an energy meridian, so a non-vital tooth may have effects beyond the tooth itself. That's a perspective, not a settled scientific fact, and it's part of why we try to keep a tooth alive when we responsibly can. When a root canal genuinely is the right call, that's okay too. At the end of the day, what matters most to me is function and being able to eat and get proper nutrition. If an implant isn't feasible because of cost, medical history, or a patient's age, then keeping a root-canal-treated tooth is better than living with a mouth full of missing teeth.

Is there a better way to do a root canal if I have to get one?

Yes. If you do need one, we send our patients to an endodontist, a root canal specialist, who uses the GentleWave system. It cleans the root canals with a powerful combination of acoustic sound waves and fluid dynamics, flushing out bacteria and debris even in complex micro-canals, and it often preserves more natural tooth structure and allows faster healing than a traditional root canal. It cleans the tooth better, though it doesn't change the fact that it's still a non-vital tooth, which in the biologic view could affect its meridian.

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