Is pulpitis the same as tooth decay?

Written by Li Bao Hua
Dentistry
Updated on September 22, 2024
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Pulpitis is actually a pain response that occurs when tooth decay further develops inflammation reaching the dental pulp tissue. Strictly speaking, pulpitis is an inflammatory pain response of the dental pulp that occurs when tooth decay further develops bacterial infection of the dental pulp tissue. Pulpitis requires early dental treatment. For tooth decay, it is sometimes sufficient to remove the decayed infected dental tissue and directly fill it. In cases of pulpitis, where the dental nerve is already exposed, anti-inflammatory treatment is necessary. First, the infected dental pulp tissue is removed with a drill, and since the dental nerve is exposed, nerve-killing is required. After controlling the inflammation, the root canal is disinfected, medication is placed in the root canal, and then the root canal is filled, which means that a complete root canal treatment is needed.

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How is pulpitis treated?

Pulpitis is an emergency in dentistry, and different types of pulpitis require different treatment methods. The first step in treating pulpitis is to administer anesthesia, and if time allows, root canal treatment should be completed in one session. Root canal treatment involves removing and cleaning the dental nerve inside the root canal in one go, then using dental cement and paste to fill the root canal, thereby inhibiting bacterial growth and reproduction. Generally, three to four root canal treatments are needed. Medication treatments include cephalosporins, erythromycin, and pain relievers to alleviate pain. Additionally, tooth extraction may be advised for severe inflammation and poor dental condition.

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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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Do I go to the Department of Oral and Maxillofacial Surgery for pulpitis?

Pulpitis requires a visit to the department of stomatology or the department of dental cariology and endodontics. Some hospitals, with more detailed department divisions, differentiate between adults and children. Generally, individuals under 18 years old fall under the pediatric dentistry department. Those 18 and older need to visit the department of dental cariology and endodontics. Pulpitis is a painful condition caused by bacterial infection of the dental nerve, clinically manifested by pain when eating, night-time pain, localized pain, and worsening pain upon exposure to hot and cold stimuli. Treatment for pulpitis involves root canal therapy. This involves drilling to remove the infected dental tissue, then performing root canal medicament filling, followed by inflammation control and root canal filling.

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Does pulpitis not require treatment?

Pulpitis must be treated promptly. Pulpitis is when the dental pulp inside the tooth cavity, where the nerves are located, gets infected or damaged. Early symptoms often include severe pain such as spontaneous pain, intermittent pain, pain due to temperature stimuli, and nocturnal pain. If the inflammation and lesions are not removed, the pulpitis can spread to the root apex with the necrotic tissue, causing destruction of the root apex tissues and leading to periapical periodontitis. If periapical periodontitis is left untreated, it can lead to cysts at the root apex, causing chronic periapical periodontitis. Periapical periodontitis may also spread to the bone marrow or adjacent interstitial tissues, leading to interstitial infections or osteomyelitis, which are very serious conditions. Therefore, pulpitis must be treated promptly. Since the pulp chamber is a closed tissue, infections typically require root canal treatment for a complete cure.

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Pulpitis alleviated by cold water

Relief from pulpitis with cold water is a typical clinical manifestation of acute suppurative pulpitis, characterized by pain with heat and relief with cold. It is common to see patients coming to the clinic holding cold water or holding cold water in their mouth to help alleviate the pain. For this type of acute suppurative pulpitis, the initial treatment should involve opening the pulp to relieve pressure. After the pressure is relieved, a devitalizing agent is used to devitalize the tissue, which is commonly referred to as "killing the nerve." Once the nerve is dead, the pulp tissue loses its sensory function, and the intensity of the pain will be alleviated.