Caries prevalence remains high throughout the world, with the burden of disease shifting to older and socially disadvantaged groups. If left untreated, caries will advance through dentine stimulating pulpitis and eventually pulp infection and necrosis; however, if conservatively managed pulpal recovery occurs even in deep carious lesions. As a profession and speciality, we should be striving to develop new biologically-based minimally-invasive solutions; however, to do so, an applied understanding of pulpitis and repair processes is critical. During this presentation we will discuss the ESE position statement of ‘Deep Caries and the Exposed Pulp’ and consider what is possible now in vital pulp treatment and what is not. During this talk we will consider amongst other things – Should we be treating more conservatively in practice, or are the results unpredictable? Is conservative treatment of irreversible pulpits realistic? Are next-generation diagnostics and targeted therapies a pipe-dream or just around the corner? Does this belong to endodontic practice or do I even want it?

Aims and Objectives:

This day will provide participants with an evidenced-based update on the controversial area of vital pulp treatment and management of the deep carious lesions. The key aims are:

1. To understand the scientific rationale and clinical arguments for pulp preservation.
2. To highlight the challenges and obstacles to successful maintenance of pulp vitality.
3. To discuss whether we should advocate avoidance of pulp exposure or whether we should embrace and manage pulp exposure as it occurs
4. To consider whether non-selective caries removal strategies are really overtreatment
5. To understand the most appropriate way of treating pulpitis
6. To evaluate whether the cariously-exposed pulp should always be removed or preserved
7. To analyse whether the term irreversible pulpitis is outdated and whether new objective pulpitis measures are a pipe dream
8. To highlight the views of dentist regarding VPT and obstacles to them carrying out recommended procedures
9. To consider outcomes for VPT and whether we are measuring the right things
10. Consider the importance of guidelines, position statements on vital pulp treatment to specialist endodontic practice.