Dentists are not recognised as pioneers of tissue regeneration but perhaps they should be as they have been using tissue regenerative techniques for almost a hundred years. Our biological understanding of healing of the dental pulp is increasing at an exponential rate. Vital pulp therapies (VPTs) offer a minimally invasive approach to the management of pulpal disease preventing the need for more invasive techniques such as root canal therapy, which can advance the tooth along the restorative cycle. VPTs have proven to be much more predictable than dogma may suggest, even in what are considered the most terminal situations such as irreversible pulpitis. Careful management of the injured or exposed pulp can result in a predictable successful outcome preserving the defence system of the tooth.