How to deal with pulpitis after pulpotomy?

Written by Fang Xiao
Dentistry
Updated on June 05, 2025
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Pulpotomy for pulpitis is the first step in root canal treatment. For patients with pulpitis, pulpotomy is typically performed under local anesthesia using pulp extraction tools to remove the pulp, including the crown pulp or root pulp, or an inactivator is sealed into the pulp chamber, and the pulp gradually necrotizes after a week. At this point, the root canal is cleaned, and the infected and necrotic tissues between the pulp chambers are prepared with root canal files to meet the treatment standards. The root canal is then filled with gutta-percha points, filling into the pre-prepared root canal until it is full, followed by filling the crown and shaping the exterior. Generally, the root canal treatment process requires two to three sessions to complete. During the acute phase, the pulpotomy is usually left open for treatment right after, and it is recommended to take anti-inflammatory medication for two to three days. After the tooth pain eases, the root canal cleaning is then carried out. Thus, it is important to maintain oral hygiene regularly, brush teeth in the morning and evening, and rinse after meals. It is vital to detect and treat dental caries early.

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Can pulpitis be cured by taking medicine?

During an acute episode of pulpitis, patients experience very severe spontaneous pain, paroxysmal sharp pain, and pain from hot and cold stimuli, which sometimes radiates to the head and intensifies at night. Medication for pulpitis is ineffective, as anti-inflammatory drugs only address the symptoms and not the root cause. In such cases, it is essential to visit a hospital, where a dentist can perform a pulpectomy, conduct root canal treatment, thoroughly treat the inflamed pulp, remove the infected dentin, apply medication inside the root canal, and then seal and fill the root canal tightly. Only through comprehensive root canal treatment can pulpitis be completely cured.

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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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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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Can a tooth with pulpitis be extracted?

Pulpitis should not be treated with tooth extraction. Pulpitis is a type of acute pain caused by bacterial infection of the tooth nerve. During an episode of pulpitis, the pain can be very severe, including dull pain, throbbing pain, and sharp pain. Sometimes cold, hot, sour, or sweet substances can stimulate the tooth nerve, leading to increased nerve pain. Sometimes pulpitis can also radiate to the temporal region, causing headaches or ear pain, and it can sometimes cause pain in both upper and lower teeth and all the teeth. Pulpitis occurs when the dental nerve has become pus-filled due to inflammation. If teeth are extracted rashly, it may lead to the spread of inflammation, causing bacteremia or sepsis. Tooth extraction is not advisable for pulpitis, but root canal treatment can be performed on the affected tooth to try to preserve it after the treatment.

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How to deal with the pain from molar pulpitis?

Pulpitis in molars can be painful and requires dental treatment. During the treatment of pulpitis, the first step is to use a drill to remove the infected dentin and bone. If the dental nerve is exposed and the inflammation of the pulp is severe, a nerve-killing treatment can be conducted. In cases of acute inflammation, it is necessary to first open up the tooth. Once the inflammation subsides, nerve-killing treatment can proceed. Otherwise, the pressure is too great and the pain may intensify. If the pain is unbearable during the drilling process in the treatment of pulpitis, local anesthesia can be administered to the tooth. Once the anesthesia takes effect, the pain will be significantly less during the drilling stage.