The Pulpotomy Notes Template UK Dentists Use
A pulpotomy notes template captures vital pulp therapy on a primary or permanent tooth — pre-op diagnosis, rubber dam, caries removal, pulp exposure assessment, haemostasis method, bioceramic/MTA/Ca(OH)2 material placement with lot number, coronal seal, post-op radiograph, and review interval — meeting BES Good Endodontic Practice 2022 and ESE S3 guideline standards.
Pulpotomy is having a renaissance — BES 2022 and ESE S3 2023 now support vital pulp therapy on permanent teeth with irreversible pulpitis as a valid alternative to RCT. Below is the template UK dentists paste into their PMS, BES-aligned.
Download the free Pulpotomy template — plain text, GDC/FGDP(UK)-aligned.
Why this pulpotomy template wins
- Rubber dam recorded as MANDATORY per BES 2022 — single most-cited indemnity gap in pulp therapy claims.
- Time to haemostasis recorded — <5min = good prognosis; >5min indicates irreversible pulpitis below and need to convert to RCT.
- Bioceramic / MTA lot number captured — MDR + medicine traceability requirement.
- BES 2022-aligned indications including irreversible pulpitis on permanent (no periapical lesion) — the modern evidence base.
- Review schedule built into the note — vitality re-check at 6 weeks + 6 months + 1 year is the standard.
Compliance: the medico-legal angle
- BES Guide to Good Endodontic Practice 2022 — rubber dam mandatory, bioceramic/MTA preferred, vitality testing at review.
- ESE S3 Clinical Practice Guideline 2023 (IEJ DOI:10.1111/iej.13974) — vital pulp therapy on permanent teeth with irreversible pulpitis without periapical lesion is evidence-based first-line alternative to RCT.
- GDC Principle 4 — operative record sufficient for another clinician to continue or troubleshoot.
- IRMER 2017 — post-op radiograph justified to confirm material placement and coronal seal.
Common mistakes UK dentists make
- NO rubber dam recorded — single biggest indemnity gap. If a child swallows or aspirates instrument, indefensible.
- No time-to-haemostasis recorded — leaves the prognostic decision (continue vs convert to RCT) undocumented.
- No lot number for bioceramic / MTA — traceability requirement.
- No post-op vitality review scheduled — pulpotomy success is judged by maintained vitality, which requires testing.
- Pulpotomy on a permanent tooth with periapical lesion — wrong indication, should be RCT.
Frequently asked questions
Can I do pulpotomy on an adult permanent tooth with irreversible pulpitis?
Yes — BES 2022 and ESE S3 2023 both now support full pulpotomy as a valid alternative to RCT for permanent teeth with irreversible pulpitis WHERE THERE IS NO PERIAPICAL LESION. Success rate ~85-90% at 2 years. Bioceramic material (Biodentine, BC RRM, MTA) is preferred. Crown follow-up required.
Why is haemostasis time so important?
It's the clinical prognostic indicator. <5min haemostasis suggests reversible inflammation in the remaining pulp — good prognosis. >5min suggests irreversible inflammation extending into root pulp — pulpotomy likely to fail; convert to pulpectomy/RCT. Document the time.
Why is rubber dam mandatory?
BES Quality Guidelines: isolation prevents bacterial contamination of the exposed pulp (the entire point of pulpotomy fails without isolation) AND prevents instrument aspiration. Indemnity case reviews consistently flag absent rubber dam as the dominant contributor to indefensible endodontic claims.
Biodentine, MTA, or calcium hydroxide?
Bioceramics (Biodentine, BC RRM) and MTA outperform Ca(OH)2 for pulp capping/pulpotomy in randomised trials. ESE S3: bioceramics or MTA first-line. Ca(OH)2 still acceptable for primary teeth in some protocols. Record what you used and the lot number.
Primary or permanent — same procedure?
Same principle, different technique. Primary teeth: usually cervical pulpotomy (remove all pulp tissue to floor of pulp chamber) using ferric sulfate or MTA, then SS crown (Hall technique variant). Permanent teeth: partial or full pulpotomy using bioceramic/MTA, then composite + future crown.
When does pulpotomy fail and what next?
Failure presents as return of spontaneous pain, swelling, sinus tract, or loss of vitality at review. ~10-15% over 2 years for permanent teeth. Convert to RCT (re-enter, remove all canal pulp, instrument, obturate, restore). Earlier intervention = better outcome.