Dental Pulp Infection (Pulpitis) A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

Dental Pulp Infection or Pulpitis is the inflammation of the pulp or nerve chamber in the tooth producing pain and pressure.
The pressure produced can induce problems with the nerves of the tooth.
This disorder can be treated if early, and normally does not lead to more problems once treated
If the disorder is not given the proper treatment, then pulpitis will ultimately cause the pulp to die.
There are two types: reversible and irreversible.
1. In reversible pulpitis, the decay has not involved the entire pulp, and the remaining tissue with its nerves and blood vessels can be saved.
Left untreated, reversible pulpitis may ultimately become irreversible in which decay is so serious that the remaining pulp, nerves, and vessels die.
Ultimately, the tooth may become discolored
Up to a certain situation, pulpitis is reversible.
The decay can be eradicated, the region around the tooth cleaned and the cavity filled.
If this is performed early enough (before the infection has become too serious) the pulp is revitalized and the tooth saved.
Left untreated, a dental abscess may develop.
2. In cases where the infection has become irreversible, root canal treatment may be needed.
The dentist will have to drill into the pulp and remove the infected material.
Once the pulp is taken out, the cavity is then filled with an inert material such as ‘gutta percha’, which is a latex derivative.
Once this intervention has been finished, the tooth is basically dead.
Very often, a crown is placed over the dead tooth to provide it extra protection.
Causes:
Dental pulp infection is mainly caused by tooth decay (caries) or it can be due to other causes, such as trauma, cracks or excessive tooth wear.
Bacteria reaches deep into the structure of the tooth.
1. Defective fillings or restorations
2. Cracks in the tooth structure
3. Traumatic injuries to the face and mouth
4. Excessive wear of the hard outer layers (enamel and dentine)
Risk factors are poor oral hygiene and a diet high in sugar.
Symptoms:
1. The major symptom of pulpitis is toothache.
The patient may also feel pain if the doctor taps the tooth with a finger.
There is normally pain when a stimulus is placed near the tooth.
The tooth normally responds to heat or sugar.
2. Discoloration of the tooth
3. Tenderness of the overlying gums
4. Abscess or swelling
Diagnosis:
1. Pulp vitality tests to determine if the dental pulp is still alive
2. X-rays (radiographs) are used to determine the extent of tooth decay
Treatment
If the stage of dental pulp inflammation is evaluated to be reversible, it can be resolved by removing the causative factors e.g. eradicating the decay and recovering or filling the tooth, occasionally with a medicament base, to restore the dental pulp to its normal healthy state.
1. Reversible pulpitis is treated in the same method as a normal filling would be done.
The involved area is treated, decay is eradicated by drilling and then the cavity left is filled.
The patient will be given antibiotics to kill off any infections.
2. Irreversible pulpitis needs a root canal and a crown to treat the problem.
A root canal is a dental procedure to eradicate dead or dying nerve tissue and bacteria in a tooth.
Antibiotics are also given.
Regenerative endodontics now attempts to restore live tissue in the pulp chamber with stem cells and growth factors.
Possible risks of root canal treatment are:
1. Abscess
2. Loss of tooth
3. Nerve damage
4. Tooth fracture
This is occasionally not always possible and the tooth might require to be removed and replaced with a dental implant.
The best way to prevent pulpitis is to have a good oral hygiene regime with prevention being better than the cure.

TABLE OF CONTENT
Introduction
Chapter 1 Dental Pulp Infection
Chapter 2 Causes
Chapter 3 Symptoms
Chapter 4 Diagnosis
Chapter 5 Treatment
Chapter 6 Prognosis
Chapter 7 Dental Abscess
Chapter 8 Gingivitis
Epilogue