Pulpitis

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Written by Li Bao Hua
Dentistry
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How is pulpitis caused?

Pulpitis is generally caused by the progression of dental caries. Bacteria infect the hard tissues of the tooth, which is referred to as dental caries in the early stages. If the decayed parts are not removed in time for dental filling, meaning the teeth are not filled promptly, the bacteria will further infect the pulp tissue, leading to pulpitis. Pulpitis is actually the outcome of further bacterial development. However, if pulpitis is not treated in time, the inflammation can advance to the root apex, causing apical periodontitis. Therefore, pulpitis requires prompt endodontic treatment of the tooth. After controlling the inflammation, the root canal is filled. Following the filling of the root canal, the top of the tooth crown is sealed, which involves the filling of the tooth.

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Written by Li Bao Hua
Dentistry
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What are the symptoms of pulpitis?

Pulpitis is a painful condition that occurs due to bacterial infection of the dental pulp tissue. Pulpitis has its own typical symptoms, including pain triggered by temperature changes. Eating foods that are cold, hot, sour, or sweet can cause severe pain in the dental nerves. Additionally, temperature stimuli intensify the pain; both cold and hot water can cause tooth pain. During the acute suppurative phase, there is pain with heat and relief with cold, meaning drinking hot water causes pain, whereas drinking cold water can alleviate it. Another typical characteristic of pulpitis includes nighttime pain; often there is less pain during the day, but at night or after falling asleep, the pain can awaken the individual from sleep.

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Written by Li Bao Hua
Dentistry
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Can a tooth with pulpitis be extracted?

Pulpitis cannot be treated by tooth extraction. Initially, pulpitis involves an inflammatory response in the pulp tissue. Extracting the tooth at this stage can cause the inflammation to spread throughout the body and, in severe cases, can lead to sepsis. Therefore, it is absolutely necessary to avoid tooth extraction during a pulpitis attack. However, dental treatment can be performed during a pulpitis flare-up. Firstly, the acute pain in pulpitis is caused by increased pressure within the pulp. The primary method involves performing a pulpotomy to relieve this pressure. Once the pressure is alleviated, root canal medication can be applied, followed by root canal filling to complete the root canal treatment and preserve the tooth.

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Written by Li Bao Hua
Dentistry
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What is pulpitis?

Pulpitis is also an inflammatory reaction occurring in the pulp tissue, caused by the further infection of bacteria when tooth decay is not timely halted, and it represents the natural conclusion of tooth decay. The dental tissues are divided into enamel, dentin, cementum, and pulp tissue, with the pulp tissue located on the innermost side, which is commonly referred to as the dental nerve. If the bacterial infection is not promptly halted in the early stages within the hard tissues of the tooth, that is, if the tooth is not filled in time, the bacteria then further infect the innermost pulp tissue, causing inflammation of the pulp tissue, which is clinically referred to as pulpitis. Pulpitis involves severe pain, necessitating prompt root canal treatment for the tooth.

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Written by Li Bao Hua
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Does pulpitis require hospitalization?

Pulpitis does not require hospitalization; it can be treated routinely in a dental outpatient clinic. Pulpitis results from the progression of caries. If dental caries are not addressed early with fillings, bacteria can infect further, reaching the dental nerves and causing symptoms of pulpitis. Severe pulpitis can cause pain when eating, pain at night, and poorly localized pain, which might radiate to the temporal area of the ear, causing intense discomfort. Routine outpatient treatments for pulpitis include nerve removal, anti-inflammation, and finally, root canal filling. A comprehensive root canal treatment can effectively resolve the symptoms of pulpitis, making hospitalization unnecessary.

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Written by Li Bao Hua
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Can pulpitis be treated by tooth extraction?

Pulpitis should not be treated by extraction. Pulpitis is simply a painful response caused by an infection of the pulp tissue and can be managed by preserving the tooth through root canal treatment. First, drill to remove the infected dental tissue, and when the dental nerve is exposed, apply a nerve-killing medication. After the nerve is destroyed, thoroughly remove the infected tissue, then seal the root canal, and after inflammation is controlled, fill the root canal. With treatment, it is possible to preserve teeth with pulpitis and extraction should not be performed. Removing a tooth during an active episode of pulpitis may lead to the systemic spread of inflammation.

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Written by Li Bao Hua
Dentistry
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How many days can pulpitis be cured?

Pulpitis can only improve by undergoing dental treatment, with most cases clinically arising from the progression of dental caries. If dental caries are not promptly filled in the early stages to halt their progression, bacteria can further infect and cause nerve damage. After a nerve-killing treatment for pulpitis, pain generally subsides. The specific duration depends on the nerve-killing medication used; some act quickly, usually within 2 days or 48 hours, killing the dental nerve and thus alleviating the pain of pulpitis. Others may act slowly, requiring about 2 weeks, or approximately 14 days.

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Written by Li Bao Hua
Dentistry
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Does pulpitis require tooth extraction?

Pulpitis does not require tooth extraction but necessitates root canal treatment. Pulpitis is a symptom caused by deep dental decay and bacterial infection reaching the dental nerves, manifesting as pain when eating or nocturnal pain. The inflammation in pulpitis is confined within the pulp and does not affect the root apex area. This infection can be resolved through comprehensive root canal treatment. The treatment begins with nerve devitalization; after the nerve is killed, infected dental tissues are removed using a drill, extracting the purulent dental nerve. Subsequently, medication is applied in the root canal. After inflammation is controlled, the root canal is filled. After treatment, the tooth affected by pulpitis can be preserved without extraction.

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Written by Li Bao Hua
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Can pulpitis be detected with an X-ray?

Pulpitis is divided into normal pulpitis and retrograde pulpitis. Normal pulpitis is a further development from bacterial infection of the hard tissues of the tooth to the pulp tissues, which means it can be captured on an X-ray. It mainly presents as a low-density image near the pulp. This stage of pulpitis is normal, developed through the normal pathway, and can be identified on an X-ray. If the pulpitis is due to the development of a periodontal pocket, bacteria infect the root apex area retrogradely through the periodontal pocket, causing pathological changes in the pulp tissue of the root apex area. Retrograde pulpitis cannot be detected on an X-ray.

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Written by Li Bao Hua
Dentistry
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Does pulpitis make it painful to tap the tooth?

Pulpitis does not necessarily cause pain when the tooth is tapped. When we talk about pain from tapping a tooth, it mainly refers to examining pain in the apical area. If tapping the tooth causes pain, it indicates that the inflammation has gathered at the root tip, manifesting as what is clinically described as tenderness upon percussion. Pulpitis may simply be a bacterial infection of the dental nerve, localized around the nerve or confined within the roots, where the nerve is infected but the apical nerve remains intact. In such cases, tapping the tooth would not cause pain. This means that in the early stages of pulpitis, there might not be tenderness upon percussion, but spontaneous pain from the dental nerve or pain triggered by temperature changes might still occur.