Pulpitis is sensitive to cold or heat?

Written by Fang Xiao
Dentistry
Updated on January 28, 2025
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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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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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How is pulpitis caused?

Pulpitis is caused by bacterial infection. The oral cavity is an environment with bacteria, and if teeth are not brushed promptly after eating, bacteria can break down food into lactic acid, leading to demineralization of the teeth. This further infection causes tooth decay and the formation of cavities. In addition to these cariogenic factors, pulpitis may also be due to periodontitis or the destruction of periodontal supporting tissues, leading to a retrograde infection. There are also large amounts of bacteria in the periodontal pocket. If the periodontal pocket is deep enough to reach the root apex, it may sometimes cause retrograde apical periodontitis. Moreover, if the teeth are malformed and are accidentally bitten off or broken during the eruption process, this can also cause inflammation of the dental nerve, which is pulpitis.

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Pulpitis has no time to treat.

Pulpitis needs to be treated as soon as possible. If pulpitis is not treated in time, it will worsen, and bacteria will further infect, reaching the apical area and causing apical periodontitis. Severe apical periodontitis may involve destructive resorption of the apical area and the alveolar bone, and inflammation may discharge pus through the mucous membrane or skin. Clinically, symptoms such as abscesses or space infections may occur, which is quite severe and can even cause systemic septicemia. Therefore, pulpitis needs to be treated as soon as possible. The treatment of pulpitis involves removing the infected dental nerve, medicating the root canal, and performing root canal filling, that is, a complete root canal treatment.

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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.

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Is pulpitis the same as tooth decay?

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.