Are We Cooking the Pulp in Its Own Juices... and Cracking It in the Process?



As dental professionals, we constantly strive to restore health and function to our patients’ teeth. But have we ever paused to consider what’s really happening beneath the surface when we prepare teeth for fillings or crowns?

When we drill, we're not just shaping the tooth — we're creating heat and friction that could be silently damaging the very pulp that keeps the tooth alive.

The Silent Dangers: Microcracks and Overheating

It’s well-known that dental drills, even when water-cooled, can raise pulp temperature by 3–10°C during routine procedures (Zach & Cohen, 1965). That might not sound like much, but it’s enough to tip the balance and cause irreversible pulp damage. And don’t forget the microcracks — those invisible fractures in the enamel and dentin that can undermine a tooth’s strength. Studies have shown that these cracks can weaken the tooth over time, making it more susceptible to fractures (Shetty et al., 2016).

Are we really helping by drilling and prepping, or are we cooking the pulp in its own juices and leaving behind cracks that’ll haunt us later?

Laser Technology: A Gentle Touch for Pulp Health

 It’s time to rethink how we approach tooth preparation. Unlike traditional drills, lasers don’t generate heat or friction. This means less thermal damage to the pulp and fewer microcracks in the enamel. Lasers work by precisely removing tissue without compromising the integrity of the tooth or its vital structures.

By using Er:YAG lasers, we can reduce the temperature increase to a safe level — typically under 2°C (Hossain et al., 2001). The water-cooled laser tip helps keep everything at a comfortable, protective temperature, preventing the rise in heat that could lead to pulp necrosis.

So, could lasers be the key to preserving what we’re trying to save — the pulp, the integrity of the tooth, and ultimately, the health of our patients?

The Bottom Line: Why It Matters

Pulp health is the foundation of tooth vitality. Heat, friction, and stress compromise it, making it vulnerable to infection, pain, and even death. When we use traditional drills, we're potentially doing more harm than good. We might be weakening the tooth with microcracks and threatening its very survival with rising temperatures.

But with lasers, we open a new door to a safer, more biologically friendly approach to dental treatment. Less heat. Fewer cracks. Healthier pulp.

Isn’t that what we should be aiming for — a future where the tooth heals better, lasts longer, and remains protected from within?

The Time for Change Is Now

It’s time to stop asking if lasers are the future of dentistry — it’s time to ask, Why aren’t we using them more?

The more we understand about the long-term health of our patients' teeth, the more we realize that the old ways might not be the best ways. With lasers, we can minimize damage, preserve tooth vitality, and promote healing in a way traditional drills can’t.

Let’s rethink how we treat pulp — because sometimes the best way to heal a tooth is to stop harming it in the first place.

References –

  1. Zach & Cohen (1965) – Pulpal response to thermal stimuli

  2. Shetty et al. (2016) – Microcrack formation after tooth preparation

  3. Kimura et al. (1990) – Laser vs. rotary cutting: thermal analysis

  4. Hossain et al. (2001) – Er:YAG laser and pulpal safety

  5. Baldissara et al. (1997) – Temperature changes during crown prep

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