Hey everyone & welcome to my first blog!
My name is Rose Thomas, and I have been invited to support education as part of the Communication Team for LASC LDC. My background is general dental practice, and I am currently working as a dentist with special interest in endodontics at Thomas & Thomas Dental Associates in Blackpool. I am also part of the Endodontology postgraduate and undergraduate teaching team at the University of Central Lancashire.
Being a dentist in the Northwest I have always found attending CPD courses to be a challenge as most of these courses with hands-on elements, which are of interest to clinicians, were based in the South. I have always been interested in education and was fortunate enough to find an appropriate postgraduate course closer to home at UCLan. Having had this opportunity it opened further development options in my career. I feel that it is important that courses in the Northwest need to be advertised & brought to the attention of GDPs, so that it helps practitioners to continually improve their skills and knowledge.
As part of my role in supporting education with Zoë, we are gathering an information resource of the CPD opportunities available locally on the LASC LDC website and shared in our regular newsletters. We have also embarked on a new collaboration with the BDA to arrange face to face CPD events locally which will facilitate education as well as networking in the profession. Please do get in touch if you have specific areas of interest which you’d like to see as future topics.
In this blog, I would like to bring some educational element regarding the latest research development in Vital Pulp Therapy (VPT) procedures, which in my opinion would be very beneficial in general dental practice. Historically, Vital Pulp Therapy was considered as a procedure to help apexogenesis for immature permanent teeth. However, with advancement in dental materials, in addition to research in this field, the Vital Pulp Therapy procedures might be opening further options for teeth which may have been deemed to have Root Canal Treatment or Extraction (AAE position statement 2021).
The AAE position statement can be accessed from:
The rationale for VPT is based on the healing potential of the remaining pulp tissue and the aim of the procedure is to provide optimal conditions for repair to preserve the vitality of the tooth. With the advent of bioactive Calcium Silicate cements, the procedure has become more predictable (BES Guidelines 2022- A guide to Good Endodontic Practice, Chapter 5).
A guide to Good Endodontic Practice can be accessed from:
This guide provides an easy to follow, step by step approach to Vital Pulp Therapy procedures with diagrammatic representation and explanation of the materials used. There is also further information on how to monitor these teeth which have undergone VPT.
Evidence is pointing in the direction that VPT, which theoretically and practically is an easier procedure, can be an alternative treatment to technique sensitive root canal treatment procedures in appropriate cases. However, we should be mindful that these findings are not based on robust Randomised Controlled Clinical trials and further clinical evidence is required to confirm these findings. I would recommend reading a few scientific articles listed below which highlights some of the current research in this area;
1. Cushley, S., Duncan, H.F., Lappin, M.J., Tomson, P.L., Lundy, F.T., Cooper, P., Clarke, M. and El Karim, I.A., 2019. Pulpotomy for mature carious teeth with symptoms of irreversible pulpitis: a systematic review. Journal of Dentistry, 88, p.103158,
2. Duncan, H.F., 2022. Present status and future directions—Vital pulp treatment and pulp preservation strategies. International Endodontic Journal, 55, pp.497-511,
3. Wolters, W.J., Duncan, H.F., Tomson, P.L., Karim, I.E., McKenna, G., Dorri, M., Stangvaltaite, L. and Van Der Sluis, L.W.M., 2017. Minimally invasive endodontics: a new diagnostic system for assessing pulpitis and subsequent treatment needs. International Endodontic Journal, 50(9), pp.825-829,
I am aware of the cost implications of using calcium silicate cements in general dental practice. Unfortunately, I am unable to provide any clarification on what band you can claim if this treatment is provided on the NHS, which further reiterates the fact that the current NHS contract is not fit for purpose, as it does not facilitate providing evidence based minimal invasive dentistry for our patients! This contract was formulated and imposed upon the profession a considerable time ago prior even to when single use files for root canal treatment became mandatory. Changes are overdue to bring in line with made to accept evidence based contemporary dentistry and the expenses associated with it. This applied across the board of treatments may, in some part, help reduce the current exodus of dentists from the NHS!
Mrs Rose Thomas
BDS, MSc with Distinction Endodontology (UCLan),
MFDS RCPS (Glasg), MJDF RCS (Eng), MFDS RCS (Ed), FHEA
Practice Partner, Thomas & Thomas Dental Associates
Senior Clinical Teacher in Endodontology, UCLan
LASC LDC member