Steps in preventing RESTORATIVE INDUCED PULP DEATH which occurs at the rate of about 10% within 5 years for the average dentist according to the literature:
1) Prepare the teeth with excessive amounts of water. Overheating the tooth by 5 degrees Centigrade will cause the pulp to die.
2) Remove all of the gross decay with diamonds and excessive amounts of water to reduce heat near the pulp.
3) Remove the last vestiges of decay including all of the caries infected and caries affected dentin with slow speed steel burs turning at a very low rate of speed and with as much air blowing on the prep as is possible (use high magnification, I use 6x DFV loupes and Mike uses 8x DFV loupes) (use excessive amounts of light) (If there is a high probability of pulp exposure then leave the last bit of caries affected dentin over the pulp chamber or pulp horn…do not leave ANY caries infected dentin and do not leave caries affected dentin that is far removed from the pulp chamber or pulp horns).
4) Bond a chemically cured core buildup using this protocol for killing microbes in the tubules and on the surface of the dentin:
Click Here to Download the Core Build Up Technique