What is pulpitis?

Written by Li Bao Hua
Dentistry
Updated on September 09, 2024
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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
Dentistry
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Does pulpitis require dental fillings?

Pulpitis requires dental restoration. Pulpitis, caused by bacterial infection reaching the dental nerve, manifests as severe pain, including sensitivity to hot and cold, nocturnal pain, and diffuse pain that cannot be localized. Typically, pulpitis in one tooth can cause pain in the adjacent upper and lower teeth on the same side, making it difficult to pinpoint the exact tooth responsible. Before performing dental restoration for pulpitis, treatment of the tooth is necessary. This includes removing the infected dental nerve, followed by medication within the root canal and controlling the inflammation. Afterward, the root canal is filled. Thus, root canal treatment is required before dental restoration can proceed in cases of pulpitis.

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Written by Li Bao Hua
Dentistry
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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 Fang Xiao
Dentistry
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Pulpitis is sensitive to cold or heat?

Pulpitis is sensitive to both cold and heat, and this sensitivity is a symptom of the condition. The dental pulp is protected by enamel and dentin, and generally does not exhibit sensitivity. However, if there are deep cavities, split wedge-shaped defects, severe wear, or fractures that compromise the outer protection, it can lead to inflammation of the dental nerve and sensitivity to temperature changes. In such cases, nerve removal treatment, also known as root canal treatment, is required. Root canal treatment involves the removal of the pulp and necrotic material from the root canal, disinfecting it, and tightly filling the root canal to eliminate any infection that could adversely affect the surrounding periapical tissue and prevent re-infection. Root canal treatment requires three to four follow-up visits and can be costly. Therefore, it is important to detect and treat cavities early.

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Can pulpitis cause headaches?

Pulpitis can cause headaches. Pulpitis is caused by the progression of dental caries, and it is the natural outcome of dental caries. Bacterial infections cause the dental nerve to become purulent and necrotic, or cause an acute inflammatory response in the dental nerve, which is pulpitis. The clinical symptoms of pulpitis include pain stimulated by hot and cold, which becomes more noticeable when consuming hot or cold food, or the pain may be non-localizable, which is also a typical symptom of pulpitis. It often happens that if one tooth suffers from pulpitis, the pain may occur in teeth on the same side of both the upper and lower jaws, and it is unclear which specific tooth is causing the pain, due to the non-localizing nature of pulpitis. Additionally, sometimes the pain may radiate towards the ear causing headaches, which is why pulpitis can lead to headaches.

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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.