In primary teeth, which statement about direct pulp capping is most accurate?

• A. In primary teeth, direct pulp capping is generally avoided; indirect pulp therapy is preferred.
• B. It is routinely performed to preserve vitality.
• C. It is less successful than indirect pulp therapy.
• D. It is the preferred method when caries is deep.

Answer: (A)

In primary teeth the goal is to keep the pulp vital while minimizing the risk of exposure and treatment failure. Direct pulp capping tends to be less reliable in primary dentition because the pulp chamber is relatively large and the dentin is thin, making the pulp more susceptible to inflammation and failure after a exposure. Plus, primary teeth undergo physiologic root resorption, which can complicate healing and seal over time. Indirect pulp therapy, by removing only the infected or most decayed dentin without exposing the pulp and then sealing with a protective liner and restoration, reduces the chance of exposure and has a higher likelihood of favorable healing. That combination—avoiding direct pulp capping in favor of indirect pulp therapy when caries is near the pulp—is why this option is the most accurate statement. In contrast, direct pulp capping is not routinely done, and when caries is deep with exposure, other approaches like pulpotomy are typically considered rather than attempting a direct pulp cap.