Symptoms before pulpitis transitions to pulp necrosis

Written by Li Cui
Dentistry
Updated on June 30, 2025
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Pulpitis is a common oral inflammation encountered clinically, with a relatively high incidence rate. Pulpitis is a disease occurring in the pulp tissue, which is a loose tissue. Inflammation of the pulp can lead to a purulent infection, causing patients to experience gum pain or facial pain that extends to the head. When pulp necrosis occurs, it generally results from the transformation of various causes of pulpitis, all due to a lack of timely treatment of pulpitis. It may also be caused by trauma, restorative materials, or certain chemical materials. It is recommended that patients seek prompt medical attention and undergo treatment such as filling and pulpal drainage for decompression; otherwise, severe clinical symptoms may occur.

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Written by Fang Xiao
Dentistry
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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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Written by Li Bao Hua
Dentistry
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Will pulpitis cause the gums to swell?

Pulpitis rarely causes gum swelling; it is generally inflammation at the apex of the tooth root that leads to it, or gingivitis causing swollen gums. Pulpitis is a bacterial infection of the tooth's hard tissues. If not treated promptly and the progression of the decay is not halted in time, it can infect the tooth nerve and cause pulpitis. At this stage, the bacterial infection is confined to the pulp tissue, which is the interior of the tooth. The gums are the supporting tissues of the teeth. If pulpitis is not treated promptly and the inflammation further progresses to the root apex area, and if the inflammation in the root apex area cannot be effectively drained, it will lead to pus discharge outward to the mucosa or skin, forming swollen gums, or a gum abscess, or swelling around the teeth due to food residue remaining after eating. Therefore, pulpitis generally does not cause swollen gums.

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Written by Wang Peng
Dentistry
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Difference between toothache due to excessive internal heat and pulpitis

Toothache caused by "excessive internal heat" usually refers to periodontal abscess or acute exacerbation of periodontal disease, whereas pulpitis involves an irreversible inflammatory reaction within the dental pulp inside the root of the tooth, and these two conditions are very different. Toothache from "excessive internal heat" related to periodontal swelling and pain refers to inflammation of the gums around the tooth. Pulpitis, on the other hand, involves inflammation of the nerves inside the tooth; thus, their specific locations are different. Toothache caused by "excessive internal heat" typically gives a feeling of the tooth being loose, but pulpitis results in localized tooth pain, which is difficult to pinpoint and can sometimes extend to include facial and head areas, presenting as radiating pain.

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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 Fang Xiao
Dentistry
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Can pulpitis heal by itself?

Pulpitis is more difficult to heal on its own. It is a disease caused by bacterial infection of the pulp tissue and is irreversible. The pulp is located inside the pulp chamber, and once inflammation occurs, it is difficult to heal on its own, and even if it heals, it is only temporary. Pulpitis requires timely treatment. If not treated promptly, the progression of the disease may lead to complications such as periapical periodontitis and periodontal abscess, which not only increase the difficulty of treatment but also cause pain to the patient, affecting their normal life. To treat pulpitis, it is necessary to remove the pulp and eliminate the infection inside the root canal with root canal treatment. Only by doing so can the tooth be preserved. Therefore, it is important to maintain oral hygiene, brush teeth in the morning and evening, rinse after meals, and use the internationally recognized Bass method for brushing.