Pulpitis: Types, Symptoms, & Treatment

Summary

Inside each of your teeth is a substance called pulp, which contains connective tissue, nerves, and blood vessels. Pulpitis is a condition that causes an inflammation of dental pulp due to bacterial infection or irritation.

Pulpitis starts as mild inflammation that, if the cause is treated, may be reversible. If allowed to progress, it can lead to the death of the tooth's pulp, the need for root canal treatment or tooth extraction, and further infection around the jaw and face.

In this article, we will discuss the common causes of pulpitis, its symptoms, and how your dentist may diagnose and treat the condition.

What is Pulpitis?

Your teeth are comprised of 3 distinct layers:

• Enamel: the hard, protective outer coating
• Dentin: the softer mid-section
• Pulp: the inner layer that contains nerves, connective tissue, and blood vessels

As the name suggests, pulpitis affects the tooth pulp, causing inflammation, pain, and increased sensitivity to temperature. Pulpitis often happens when cracks or cavities in teeth allow bacteria to enter, or when irritation occurs within a tooth due to grinding.

Types of Pulpitis

Pulpitis is classified based on the extent to which the infection has advanced. Types of pulpitis include:

• Reversible Pulpitis: In its early stages, pulpitis causes milder inflammation and pain. Any damage to the tooth pulp can be reversed, and the source of irritation can be removed entirely by a dentist who repairs and seals the tooth.
• Irreversible Pulpitis: If left untreated, inflammation and damage caused by pulpitis will cause tooth pulp to die. In these instances, a root canal or full tooth extraction may be necessary.

Pulpitis Symptoms

You may experience a range of pulpitis symptoms depending on how advanced your case is, but the main effect of the condition is pain. Both types of pulpitis may also cause increased sensitivity to hot and cold foods.

Reversible pulpitis symptoms include:

• Inflamed tooth pulp
• Soreness and toothache
• Short, sharp pains when in contact with hot and cold food

Irreversible pulpitis symptoms include:

• Longer, throbbing pain when in contact with hot and cold food
• Bad breath and a bad taste in the mouth
• A fever
• Pain when the affected tooth is touched
• Swelling around the gums

If pulpitis progresses, the pulp in your tooth may die; this is called pulp necrosis. Symptoms of pulp necrosis may vary slightly, as temperature sensitivity often disappears while pain may remain at the same level.

Causes of Pulpitis

Typically, our enamel and dentin protect our tooth pulp, with their hard, unbroken layers preventing bacteria from entering the pulp. When the structure of a tooth is compromised and enamel or dentin breaks down, tooth pulp is exposed, and bacteria can make their way into it and cause pulpitis.

Common reasons for tooth pulp becoming exposed include:

• Oral trauma causing injury and breaks to a tooth.
• Repetitive trauma, such as that caused by teeth grinding (bruxism) or jaw misalignment.
• Gradual decay or a tooth cavity.
• A cracked or lost filling, or a dental restoration that is no longer properly sealed.

Certain lifestyle factors can increase your risk of pulpitis as they increase the risk of exposed pulp. These include:

• Neglecting oral health
• Regularly engaging in a sport or hobby that involves mouth trauma, i.e. boxing
• A poor diet with high in sugar and acid

Diagnosing Pulpitis

If you are worried that you may have pulpitis, then you should visit your dentist.

First, a dentist will use an X-ray to examine the tooth's structure, identify the extent of decay, and look for changes in the bone surrounding the root that may indicate infection.

To diagnose the extent of damage to your tooth pulp, your dentist may perform a sensitivity test. These include:

• Electric Tooth Pulp Tests: A small electrical pulse is sent to your tooth pulp to check if it is alive. If you can feel the pulse, your tooth pulp is alive; if not, it is likely dead.
• Temperature Tests: A hot or cold probe is placed on the tooth. If you are sensitive to the change in temperature, the pulp is alive; if not, it is likely dead or necrotized.
• Percussion Test: Your dentist gently taps on the tooth with a small instrument to see whether it feels tender. Tenderness during this test can be a sign of irreversible pulpitis.

Pulpitis Treatment

Once diagnosed, the pulpitis treatment your dentist recommends will depend on the extent of your infection. For minor and reversible pulpitis, treatment will focus on treating the cause of inflammation and reducing the chance of reinfection. This often involves removing decayed areas of the tooth and resealing them to prevent future bacterial entry.

Irreversible pulpitis will require more serious treatment, potentially with a specialist. The two most common treatment options used for irreversible pulpitis are:

• Root Canal Treatment: A root canal is a treatment used to remove infected tooth pulp. It is performed by a dentist or a specialist dentist known as an endodontist, who opens the tooth, removes the infected pulp, fills the root canal, then fills the tooth and seals it to avoid reinfection. A successful root canal will save the tooth from extraction and prevent future infection.
• Tooth Removal: In some cases of irreversible pulpitis and pulp necrosis, it may not be possible to save your tooth. In this instance, a tooth removal (extraction) will be performed to stop the spread of pulpitis to other teeth and the jaw.

Pulpitis Complications

If pulpitis is left untreated, it can have some serious complications. Irreversible pulpitis can cause infection and painful abscesses at the root of the tooth called periapical abscesses. An infection in the root of the tooth is potentially dangerous and can spread into the jaw, neck, chest, and even the brain if left untreated.

Signs of an infection include pain around the root of the tooth and the site of infection, a fever, and swollen glands. If you experience these symptoms, visit your doctor as soon as you can.

Pulpitis Prevention

Pulpitis can be a serious condition, but there are several lifestyle changes you can make to help lower your risk.

The best way to prevent pulpitis is with good oral care. Brushing your teeth twice a day and flossing regularly will keep your teeth clean and help reduce the buildup of bacteria. Regular dentist visits are also recommended to check for cavities, tooth decay, and other risk factors for pulpitis.

You should also use a mouthguard if you grind your teeth at night or take part in any activities with a high risk of oral trauma. If you suspect you have a cracked tooth or any break in your enamel, visit your dentist as soon as you can to reseal the tooth.

Stop Dental Problems in Their Tracks

When it comes to preventing conditions like pulpitis, a consistent and effective oral care routine is key. Keeping your mouth clean and well maintained can help support overall oral health and Oral-B is here to support you every step of the way.

Oral-B iO Series electric toothbrushes give your teeth a deep clean while being gentle on sensitive areas. Along with regular dental checkups to catch early signs of pulpitis or tooth decay, using quality oral care tools helps keep your mouth healthy.

Oral-B champions a proactive approach to oral health by encouraging you to maintain daily care habits that help preserve your smile and support but protect the health of your teeth from the inside out.