Is there any way to avoid a root canal when cleaning out a deep cavity?

When treating a patient with a deep cavity I have a particular way of cleaning out the decay in order to minimize the likelihood of exposing the nerve. I carefully and gently remove the decay from the sides walls of the cavity preparation and when my access is completed and the walls are clean, I finish cleaning the part of the tooth closest to the pulp.

Sometimes I am able to avoid root canal treatments by placing medicament's over affected dentin before placing the final restoration. "Affected Dentin" is another word for softened dentin, that has been affected by the bacteria in the decay, but can be retained if treated with dycal and vitrabond or dycal and IRM. Most dentists remove this tooth material instead of preserving it. When removing it , they can expose the pulp and the patient then needs a root canal.

I do not advocate performing direct pulp caps, but instead make use of this "indirect pulp cap procedure". In my experience this procedure has a high success rate. Direct pulp caps involve placing material directly over small pulp exposure. Although I have done these on occasion, they are not as predictable.