Pulpitis

Pulpitis is medical condition in which the dental pulp becomes inflamed.

Symptoms

Increased sensitivity to stimuli, specifically hot and cold, is a common symptom of pulpitis. A prolonged throbbing pain is also associated with the disease.^[1]

Causes

Pulpitis may be caused by a dental caries that penetrate though the enamel and dentin to reach the pulp, or it may be a result of trauma, such as thermal insult from repeated dental procedures.

Inflammation associated with a bacterial infection, as in the case of penetrating decay, the pulp chamber is no longer sealed off from the environment of the oral cavity.

When the pulp becomes inflamed pressure begins to build up in the pulp cavity exerting pressure on the nerve of the tooth and the surrounding tissues. Pressure from inflammation can cause mild to extreme pain, depending upon the severity of the inflammation. Often, pulpitis can create so much pressure on the tooth nerve the individual will have trouble locating the source of the pain, confusing it with neighbouring teeth. Inflammation in the tooth provides a difficult environment for reducing the inflammation in the pulp cavity. Unlike other parts of the body where pressure can dissipate through the surrounding soft tissues and where lymph can reach, the pulp cavity is very different. The dentin surrounding the pulp is hard and does not give under the pressure of the inflammation so the pressure has very little chance of dissipating before pulpal necrosis occurs. The pulp cavity inherently provides the body with an immune system response challenge, which makes it very unlikely that the bacterial infection can be eliminated. The pain will usually stop once the pulp has died, however the infection can spread to the ancillary anatomy.

Treatment

Once the pulp has become inflamed the tooth can be diagnostically divided into two categories.

• reversible pulpitis
• irreversible pulpitis

Reversible pulpitis

Once the irritant is removed the pulp remains vital and is not unduly affected by the changes, and the tooth can be restored vital by filling.

Irreversible pulpitis

The pulp is irreversibly damaged and necrosis will follow. Pain may not subside after removal of the irritant. Pain may be sharp or dull and throbbing. If there is any drainage, then the severity of pain is reduced.

The tooth may be endodontically treated where by the pulp is removed and replaced by gutta percha. An alternative is extraction of the tooth. This may be required if there is insufficient coronal tissue remaining for restoration once the root canal therapy has been completed.

References

1. ^ "Pulpitis". The Aberdeen. 17 September 2003. pp. 3. http://news.google.com/newspapers?id=akUMAAAAIBAJ&sjid=WmMDAAAAIBAJ&dq=pulpitis&pg=6295%2C1357862. Retrieved 4 September 2009.