New Facts About Deep Cavities | 医療法人社団EPSDC

Easy-to-Understand Guide for People

How we treat deep cavities has changed a lot. Today’s world standard is “protect the tooth’s nerve (pulp) as much as possible.” We don’t over‑drill; instead, we help the tooth last longer by using its natural strength.

Key Points (simple summary)

– How treatment has changed

– Before: Drill out all the decay and fill it (this often led to removing the nerve if decay was close to it).

– Now: To protect the nerve, we may intentionally leave a little soft decay near the nerve and seal it tightly. This is the standard approach.

– What protects the nerve

– Drill as little as possible (less burden on the tooth).

– Keep the area very clean during treatment using a rubber sheet (rubber dam).

– Use magnification and proper disinfectants carefully.

– Two ways to remove decay

– Selective removal (SE): Leave a small amount of soft decay very close to the nerve and seal the cavity firmly.

– Stepwise removal (SW): Treat in two visits—leave some decay first, then complete the final treatment a few months later.

→ Both methods reduce the chance of exposing the nerve.

– Cavity “liners” are not routinely needed

– In the past, we routinely placed a protective layer (medicine) at the bottom. Now we know it’s “not needed every time.”

– Whether used or not, success rates and pain do not change overall.

– Even with strong pain (irreversible pulpitis), there is hope

– Before: The usual treatment was to remove all the nerve (root canal).

– Now: “Pulpotomy” (removing nerve only in the crown, keeping the root nerve) is a strong option.

→ This helps the tooth stay stronger and reduces the chance of cracking.

– Materials have improved

– “Bioceramics” such as MTA (HCSC) have higher success rates than older materials (like calcium hydroxide).

What this progress means for you

– There is a greater chance we can keep your nerve alive.

– We can reduce over‑drilling, pain, and treatment time.

– You receive care based on top‑level, worldwide guidelines—treatment you can trust.

Our promise

– We follow the latest international guidelines, avoid removing the nerve unnecessarily, and help your tooth heal using its natural ability.

– We use a rubber dam, magnification, and a clean, safe setup for careful treatment.

Please consult us early

– Sensitivity to cold, throbbing pain, or pain when biting can be a “chance to save the nerve.” Early visits help your teeth last longer.

Reference

Schwendicke, F., Kosan, E., Banerjee, A., Baysan, A., Bjørndal, L., Ceballos, L., … & Dujic, H. (2026). Deep caries management: EFCD-ESE-ORCA S3-level clinical practice guideline. Caries Research.

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