Reversible and Irreversible Pulpitis: Causes and Treatment

If you notice a tingling sensation in one of your teeth or a sharp pain when eating something hot or cold, you may be dealing with pulpitis. This condition occurs when the inner pulp portion of the tooth, which is made up of blood vessels and nerves, becomes inflamed. The inflammation is usually reversible, but there are times when the inflammation isn't reversible and the pulp can't heal itself. In either case, a visit to the dentist is necessary.

What Causes the Inflammation and Pain?

According to the Merck Manual, deep cavities close to the pulp, trauma to a tooth, crown preparations, repeated invasive procedures, a cracked tooth and grinding and clenching your teeth are all scenarios that can inflame the blood vessels in your pulp. These vessels then press on the nerves, causing discomfort.

If your pain occurs with temperature extremes but goes away quickly, you may have a reversible condition. But if the pain is intense, lingers after temperature changes, occurs unprompted or is scattered, making it hard to determine the exact location, you may have irreversible pulpitis.

Regardless of the type of pain you have, see your dentist right away for an evaluation, which may include X-rays. Your dentist will take the right measures to treat the pulp and stop the pain.

Treating Reversible Pulpitis

According to the Canadian Dental Association, if pulpitis is reversible, the inflammation and discomfort go away when you resolve the source of the irritation. For example, if the pulp in your tooth is inflamed because decay has reached the nerve endings, removing the decay and placing a filling allows the pulp to recover and eliminates any further discomfort.

If reversible causes are left untreated, though, bacteria will eventually reach the pulp. This can cause infection and damage that can't be reversed.

Treating the Irreversible Type of Pulpitis

When the condition is irreversible, pulpal inflammation does not go away even after removing the cause. That's because pulp starts to die once it loses its blood supply due to swelling. The dead tissue is broken down by your body's immune system, but if there is too much infection and dead tissue for your immune system to handle, an abscess can form. The infection may spread to the surrounding bone or other areas of the body.

In these cases, an endodontist must perform a root canal to remove the dying pulp, which will stop the pain. The only other option besides a root canal is tooth extraction, which is usually not the treatment of choice.

Preventing Pulpal Inflammation

In cases other than accidental trauma to a tooth, there is a lot you can do to preserve your smile. Follow a good homecare routine that includes daily flossing and twice-daily brushing with a toothpaste like Colgate Cavity Protection, which helps protect teeth against cavities and cleans teeth thoroughly. Proper oral care also helps the longevity to your existing fillings that protect your pulp.

Scheduling regular visits with your dentist can help them identify any areas of decay while the decay is small and nowhere near the pulp.

If you grind your teeth, you may want to consider wearing a mouth guard while you sleep.

Even with proper prevention methods, tooth pain or sensitivity may happen. Bring it to the attention of your dentist as soon as possible. Caught early, a simple treatment may keep your pulpitis a reversible condition, rather than an irreversible one.

This article is intended to promote understanding of and knowledge about general oral health topics. It is not intended to be a substitute for professional advice, diagnosis or treatment. Always seek the advice of your dentist or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.

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