Pulpitis is inflammation of the dental pulp that locates in the center of the tooth. This dental pulp inflammation may be associated with untreated tooth decay, accident injury, facial trauma or repeated dental procedures. Core symptom is pain. However, the level of painful feeling varies. There is strong possibility that pulpitis is treated successfully at early stage to save your natural teeth. If left untreated, inflammation can spread to other structure of the tooth (periodontal structure,..), which puts tooth at risk of loss.
Cause of pulpitis
At the centre of each tooth is a soft tissue known as “dental pulp.” This pulp is made up of blood vessels, nerves, and connective tissue that are sensitive to any infection. Once hard layers of tooth are damaged, bacteria penetrate into the crack and attack directly the soft pulp, causing pulpitis.
- Tooth decay - main cause of dental pulp infection: Untreated caries become so large and deep that it approaches the pulp.
- A gum abscess (or periodontal abscess) originates from a gum pocket outside of the tooth, which affects reversibly to the dental pulp
- Accident causes injury to the teeth (such as a blow or other face attacks..), resulting in exposure of pulp chamber
- Sudden change in temperature of food/ drink affects the dental pulp
- Tooth wear/ Fractured tooth: Brushing too hard or with wrong technique in long time may lead to tooth abrasion, causing exposure of dental pulp.
- Old-aged people easily have tooth wear that exposes the normally protected pulp to bacteria and food particles
- Repeated dental procedures disturb dental pulp tissue, or dental treatment such as a crown or a filling that get too close to the pulp chamber.
Stages of pulpitis and associated symptoms
Phase 1: Reversible pulpitis
There is not much recognizable symptoms at the initial stage of pulp infection. Symptoms typically include mild pain, or tooth sensitivity upon eating or drinking something very hot, or cold, which are easily ignored by the patients. In some cases, pulpitis may occur even without any pain. This initial stage only lasts in short period of time. If the disease is diagnosed soon at this phase, the treatment can offset reversible pulpitis.
Phase 2: Irreversible pulpitis.
Patients face many difficulties in this phase. The symptoms are much more obvious to be aware of, which include:
- The level of pain begins to intensify and a sharp pain may be experienced in the infected tooth. Additional swelling around your face and/or neck
- Prolonged painful response to stimuli
- An abscess or lesion formed on the gum area surrounding the tooth, similar to a small pimple or blister
- Bitter and/or sour tastes in the mouth
- Extreme sensitivity or pain in your tooth when exposed to either hot or cold food/drink that lasts beyond the removal of the hot or cold food/drink
Phase 3: Necrotic (dead) pulpitis
The later stages of tooth abscess involve not only the pulp necrosis but also the spread of the infection to neighboring structures. The infection can spread to the alveolar bone, the bone that supports and holds the tooth. The abscess can eat away at the bone tissue, leading to bone loss and a loosening of the affected tooth. If bone loss around the tooth is significant, the infected tooth must be extracted. The worst scenario is that the late stages of tooth abscess can develop into potentially fatal infection
Dr. Philippe Guettier – endodontic specialist - founder of Minh Khai Dental Clinic
At Minh Khai Dental Clinic, dentists are often received knowledge updated and trained by Dr. Philippe Guettier - founder of the clinic. Dr Philippe Guettier graduated in Medicine at the University of Paris VII in 1984 and specialized in Dentistry at Garancière Paris VII Dental School, in 1988. In 1989, he got his post-graduate certificate in Dental Biomaterials. In 1990, he received his post-graduate certificate in Endodontics and a post-graduate certificate in Periodontology in 1991. Since 1995, Dr Guettier has also been continuously involved as a consultant in the research and development of new endodontic products for leading dental manufacturers. Dr. Philippe Guettier has been training root canal treatment.