Treating tooth decay costs the NHS over £3.4 billion each year. Where the tooth decay has spread deep into the nerve and caused serious and irreversible damage (called irreversible pulpitis), there are different treatments available. The most common treatments are to take out the tooth or use root canal treatment. Root canal treatment removes all the nerve and can be time consuming and technically demanding. A possible alternative is to remove only the inflamed part of the nerve, which is a less invasive treatment. This technique is called pulpotomy.
The PIP study has been funded by the NIHR HTA to investigate patient, clinical and economic outcomes for partial irreversible pulpitis, the initial stage of the irreversible damage confined to the coronal (crown) pulp whilst the radicular (root) pulp remains vital. Removal of the coronal pulp with a Full Pulpotomy (FP) may keep the radicular pulp vital and thereby avoid the need for complex Root Canal Treatment or extraction.
The initial feasibility study aims to identify the training needs of General Dental Practitioners (GDPs) to undertake pulpotomy treatment; develop a clinical training package, assess if this can be delivered optimally in routine NHS practice, and estimate number of eligible patients per practice and recruitment materials for the main trial. The success of the feasibility study will determine progression to a pragmatic, multi-centre, two-arm randomised controlled trial in 50 primary dental care practices from across the UK. This main trial will aim to compare the clinical and cost effectiveness of pulpotomy compared to root canal treatment in pre/molar teeth of 530 adults with symptoms indicative of irreversible pulpitis.
The study is being led by Professor Jan Clarkson based at the Dental School of the University of Dundee.