Which irrigant is used to achieve haemostasis within the pulp chamber during vital pulp therapy?

Correct answer: C. Sodium hypochlorite

• A. Chlorhexidine is an excellent antimicrobial with good substantivity, but it has no haemostatic action.
• B. Saline is inert — it rinses debris but neither disinfects nor stops bleeding.
• C. CORRECT. SODIUM HYPOCHLORITE, typically at 1.5 to 6%, is applied on a cotton pellet for one to ten minutes to arrest pulpal bleeding before placing a capping material. It works by protein coagulation and vasoconstriction while simultaneously disinfecting the exposure and removing the fibrin clot that would otherwise block the capping material's contact with the pulp.
• D. EDTA is a chelating agent for removing the inorganic smear layer. It has no haemostatic effect and would worsen bleeding by demineralising dentine.

Note: Haemostasis is diagnostic as well as therapeutic. If bleeding stops within a few minutes the pulp is judged healthy enough to cap. If it continues past roughly ten minutes the inflammation extends deeper than the exposure, and the case is converted to pulpotomy or full pulpectomy. Other haemostatics used here include ferric sulfate and 2% chlorhexidine as an adjunct.