Pulpitis is an inflammatory change in the nerve of the tooth. It affects the soft inner part of the tooth (the pulp). The most common cause of pulp inflammation is tooth decay. Simple reversible pulpitis can often be treated with anti-inflammatory medication. Severe or chronic irreversible pulpitis, on the other hand, requires root canal treatment to save the tooth.
Here you will find further information and selected pulpitis specialists and centers.
An inflammation of the pulp inside the tooth is called pulpitis. It is caused by
caused. The inflammatory process can extend into the root canal and the jawbone. In the worst case, there is a risk of complete tooth loss.
Colloquially, pulpitis is also referred to as inflammation of the dental nerve. However, this is only partly true. It is not just the dental nerve that is inflamed, but the entire pulp inside the tooth. Blood and lymph vessels also run here.
In general, a distinction is made between reversible and irreversible pulpitis.
If the irritation of the pulp is only of short duration and is treated quickly, an improvement often occurs quickly. The pulpitis can then be completely cured. It is therefore reversible.
If pulpitis is not treated, the pulp is exposed to constant irritation. The inflammation then becomes chronic and in many cases the pulpitis is irreversible. As a result, localized
The tissue inside the tooth dies. If the tooth is to be preserved, i.e. not extracted, root canal treatment is then necessary. The procedure is time-consuming and quite painful. The dead nerve and other tissue inside the tooth is removed and holes are sealed.
Illustration of the different stages of dental caries © Peter Hermes Furian | AdobeStock
Pulpitis can have many different causes. Caries is by far the most common trigger for inflammation of the pulp, accounting for around 95 percent of cases.
Deep caries leads to cavities in the tooth. They extend to the pulp and allow bacteria unhindered access to the sensitive pulp.
Much less frequently, pulpitis is the result of an injury to the tooth or open dental treatment. The pulp can also be exposed due to accidents or during dental treatment and attacked by bacteria.
Open tooth injuries should therefore be treated as quickly as possible to prevent secondary damage such as pulpitis.
Acute pulpitis is painless in the initial stages. The affected person only reacts sensitively to external stimuli such as
If pulpitis remains undetected and untreated, the pulp reacts to the inflammation. The tissue is supplied with more blood in order to counteract the inflammatory changes. The small blood vessels in the pulp now release more serum into the surrounding tissue. This leads to swelling of the pulp.
However, the pulp cannot expand indefinitely due to the firm tooth walls. This leads to a significant build-up of pressure inside the tooth. Nerves, lymph and blood vessels are compressed. This causes spontaneous, sometimes throbbing or throbbing pain. At the beginning, the pain is intense but quite short.
In most cases, the pain radiates in all directions of the jaw. It is therefore very difficult to pinpoint the exact location. Many patients can only name the affected side of the face as the pain trigger, not the exact tooth affected.
Over time, however, the pain-free intervals between the onset of pain become shorter and shorter. Then a persistent, throbbing and very severe pain sets in.
If the pulpitis is not treated at this point, necrosis of the pulp can occur. This is the complete death of the pulp. If the nerve in the tooth dies, it cannot transmit pain. The pain therefore diminishes and disappears completely. This is relieving for the patient, but is a negative sign of a severe, working inflammation.
In the case of severe pulpitis that has already spread to the root canal of the tooth, pus may also form inside the tooth. The pus then bursts outwards and causes bad breath and an unpleasant taste in the mouth.
If the inflammation penetrates into the jawbone, a pus cavity may form there. The pus eats into the bone tissue, which is associated with severe pain. It also causes damage to the periodontium and jawbone.
As a result, the tooth can become loose and fall out. If left untreated, the inflammation can also spread in extreme cases. This means that the entire oral cavity can become inflamed or even lead to blood poisoning.
In general, you should consult a dentist if you have toothache. During the consultation, the dentist will ask you about the exact symptoms and any accompanying illnesses.
During the subsequent examination, the dentist will check the affected tooth for abnormalities such as
Using a dental probe, the dentist taps lightly against the tooth. A healthy dental nerve only registers the tapping. An inflamed dental nerve reacts to the touch alone with a painful stimulus.
During the examination, the dentist must rule out other possible causes for the discomfort. Similar symptoms exist, for example, with
For further diagnostics and to determine the extent of the pulpitis, an X-ray is taken. It quickly provides information about
In the case of acute, non-chronic inflammation of the pulp, treatment is still quite simple. In many cases, it helps to eliminate the underlying disease. It is then sufficient to remove the caries from the tooth and close the resulting hole properly. The pulp is then no longer exposed to direct stimuli. In most cases, the inflammation will then subside on its own.
Anti-inflammatory medication can be prescribed to support the process. They are available in the form of tablets or gels for local application.
In the case of advanced, chronic pulpitis, treatment is no longer quite so simple. In most cases, only root canal treatment and removal of the entire pulp is effective.
The tooth is opened under local anesthesia. The dentist removes the pulp together with the focus of inflammation from inside the tooth. The resulting cavity is cleaned and carefully filled with a special filling material to make it bacteria-proof. The tooth opening is then closed again.
It may be sufficient to first seal the opening of the tooth cavity with cement for protection and then rebuild the tooth with an amalgam or composite filling.
If this method cannot completely guarantee the stability of the tooth, the tooth must be capped with a dental crown. This decision depends on how much healthy tooth dentin had to be removed.
Extracting the pulp can prevent the inflammation from spreading to the periodontium and the jaw. This makes it possible to preserve the tooth.
If a localized focus of pus also occurs, in some cases this must be opened and the pus removed. This prevents the inflammation from spreading to other parts of the dentition.
Antibiotics must also be administered for all-round treatment. Antibiotic treatment is given
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