Aim: The aim of this study was to evaluate the available evidence on direct pulp capping, partial pulpotomy and root canal treatment performed on young permanent teeth with vital pulps exposed due to caries. In order to determine whether and, if so, under which circumstances these pulp capping therapies can be more beneficial than root canal treatment in regard to maintaining or achieving a symptom free tooth with normal periapical conditions, a systematic review of the literature was performed. Methodology: Database searches in PubMed, Web of Knowledge, and the Cochrane Library was performed. Reference lists of relevant articles were hand searched. The level of evidence of each publication was assessed by the authors and publications were appraised to have a high, moderate or low level of evidence. Results: The initial database searches yielded 1908 publications. Twelve original scientific studies, 10 concerning pulp capping therapies and 2 concerning root canal therapy, were included and assigned a level of evidence. Both pulp capping therapies and root canal treatment showed high short term success rates, but all studies were regarded as having a low level of evidence. Conclusions: The overall evidence grade of the effectiveness of the treatments is insufficient. However, the current best evidence presents promisingly high short term success rates for pulp capping and partial pulpotomy as alternative treatments to root canal therapy in permanent teeth with pulp exposure due to caries in children and adolescents, but the insufficient evidence emphasizes the demand of more high quality studies being conducted.