NIH funds national center to advance root canal alternatives

Which would you rather have: a root canal or a pulpotomy? Even if you're not familiar with a pulpotomy, you might be inclined to learn more.

That is what a new national center has started to explore, funded with nearly $2 million from the National Institutes of Health, and co-led by principal investigator Rahma Mungia, BDS, MSc, DDPHRCS, associate professor in the School of Dentistry at The University of Texas at San Antonio.

While a root canal often is performed for a tooth that is deeply decayed and painful, drilling into its top to remove inflamed pulp tissue inside and sealing with a crown, the procedure usually must be referred by your general dentist to an endodontic specialist.

With that can come a second appointment, a new office, time away from work and another bill. In places where endodontists are scarce, the wait can be long, and some patients never complete the referral.

But research suggests that a pulpotomy – sometimes called vital pulp therapy, in which inflamed tissue is removed from inside the crown of the tooth while preserving healthy pulp tissue in the roots, relieving pain while saving the tooth – could be done more often in a general dental practice for select patients.

It might not be appropriate for every patient, as sometimes a root canal is unavoidable. But for appropriately selected patients, it might provide a tooth-preserving treatment without the need for immediate root-canal therapy.

Kenneth M. Hargreaves, DDS, PhD, Dean of the UT San Antonio School of DentistryAs an endodontist, I know how much it means to a patient to stop the pain and keep their natural tooth. This alternative approach may help general dentists and endodontists offer it safely to the right patients."

Closing the gap between what research supports and what happens in everyday clinical practice is the focus of the new NIH award establishing the National Dental Practice Training Center (NDP-TC), a collaboration of the UT San Antonio Health Science Center with the University of Alabama at Birmingham and the University of Rochester, together with the National Dental Practice-Based Research Network and the Project ECHO Superhub based at UT San Antonio's health science center.

The National Dental Practice-Based Research Network is a U.S. consortium in which dental clinics and researchers work together on real-world patient care studies. Project ECHO (Extension for Community Healthcare Outcomes) is a virtual training and mentoring framework that helps local health providers treat complex medical conditions in their own communities.

Joining Mungia as co-leader and principal investigator of the new center is Joana Cunha-Cruz, DDS, PhD, professor at the UAB School of Dentistry. Together, they will lead the development, implementation and rigorous evaluation of the national training platform, beginning with pulpotomy. Mungia also leads the Southwest Regional Node of the National Dental Practice-Based Research Network and directs the South Texas Oral Health Network.

Translating evidence to clinical practice

Source:

The University of Texas at San Antonio Health Science Center