How is pulpitis treated?

Written by Tian Hua
Otolaryngology
Updated on March 17, 2025
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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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Written by Li Bao Hua
Dentistry
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How to relieve the pain of pulpitis?

The pain caused by pulpitis can be alleviated through medication or root canal treatment. Pulpitis, a severe pain resulting from bacterial infection of the dental nerve, can sometimes radiate to the temporal area, causing ear pain or headaches. If not treated promptly, oral pain relief medications can be used for temporary relief; however, these drugs only serve as an adjunctive therapy and do not fundamentally resolve the tooth pain. The definitive solution requires root canal treatment, which relieves the pressure within the pulp chamber, alleviating the pain of pulpitis. After alleviation, further dental treatment is necessary. If the teeth are not treated following relief, further infection might lead to apical periodontitis, and in severe cases, can result in facial cellulitis, also known as a space infection.

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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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What should I do if the pain from pulpitis is unbearable?

Pulpitis typically presents with spontaneous pain, paroxysmal pain, and pain due to temperature stimuli. The pain of acute pulpitis often cannot be localized. Only by visiting a regular hospital's dentistry department for pulp opening and drainage can the pain be relieved, followed by comprehensive root canal treatment. Additionally, if it is inconvenient to treat pulpitis pain, one can take oral anti-inflammatory painkillers, apply ice locally, crush a clove of garlic and place it on the affected tooth, or steam one part Sichuan pepper with four parts aged vinegar for ten minutes and then apply the moistened Sichuan pepper to the affected tooth to alleviate the pain. Ultimately, root canal treatment at a regular hospital's dentistry department is necessary. Regular oral hygiene is important, including brushing teeth morning and night, rinsing after meals, and using the internationally recognized Bass brushing technique. Cavities should be detected and treated early.

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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.

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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.