Laser Direct Cap – Avoiding a Root Canal

The guiding principle of biological dentistry, “First Do No Harm,” requires to consider a root canal procedure, which leaves the tooth as a dead object within the body, as a very last resort.

Instead of the ‘brute force’ method to treat an infection of the tooth by removing all living tissue, every effort is made to heal the infection and leave as much of the tooth as possible undisturbed.

The Direct Laser Cap procedure can be used in the earlier stages of an infection caused by a cavity reaching the pulp.

The following points describe the development of this early infection and the treatment with the direct laser cap procedure:

  1. HEALTHY TOOTH: A healthy tooth is covered by a shell of enamel, the hardest substance in the body. It is a complex organ comprised of all three embryological layers.
  2. CAVITY FORMATION – EARLY STAGE: A cavity starts when bacteria in plaque produce acids which eat away at the surface of the enamel.
  3. CAVITY FORMATION – DENTINE INVASION: As the cavity penetrates the softer dentine, it spreads like a wave and infects the microscopic tubes of this live tissue.
  4. CAVITY FORMATION – DEEP DECAY: Very soon it approaches the nerve chamber, or the pulp, causing an inflammation which, at this stage, is reversible. This is when one feels mild pain or heightened sensitivity to sweets and cold.
  5. DRILLING OUT GROSS DECAY: Treatment is initiated by removing the outer layers of decay with a slow drill.
  6. LASER EXCAVATION AND DECONTAMINATION: The deep layers of decay are removed with the Waterlase® at lower settings, to avoid trauma to the nerve. There is no mechanical insult to the nerve, such as vibration, smearing or heat, which is the case when using drills. The infected dentine is thus removed completely, resulting many times in an exposure of the pulp.
  7. EXPOSED PULP: If the nerve (pulp) is still healthy, it may bleed slightly. At this stage the exposure is treated like a wound. It is gently irrigated with hydrogen peroxide, followed with an isotonic homeopathic remedy.
  8. DIRECT CAP: The exposure is gently covered with MTA, a cement well known for its biocompatibility and ability to preserve vitality of tissues with which it comes into contact.
  9. CORE BUILDUP: The remaining cavity is then lined with a self-priming bonding agent without disturbing the MTA. After drying, the whole dentine surface is built up with a core of a flowable composite or compomer.
  10. FINAL RESTORATION: The tooth is restored with an esthetic, tooth-colored bonded restoration, preferably an indirect porcelain inlay or onlay.

The biomimetic principle is followed, which means that each part of the tooth that was restored, functionally mimics the biological tissue it is replacing.

Graphical Presentation

You find illustrations outlining the Laser Direct Cap procedure at the blog Homeopathic Dentistry.