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Reversible And Irreversible Pulpitis: Causes And Treatment

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Medically Reviewed By Colgate Global Scientific Communications

If you notice a tingling sensation in one of your teeth or sharp pain when eating something hot or cold that goes beyond regular tooth sensitivity, you may be dealing with pulpitis. Pulpitis 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, it's best to visit your dentist for treatment so they can help get you on the road to recovery.

What Causes Inflammation and Pain From Pulpitis?

Bacterial infection is the most common cause of pulpitis. However, many things can increase your chance of getting pulpitis. Some of these include:

  • Deep cavities close to the pulp
  • Trauma to a tooth
  • Crown preparations
  • Repeated invasive procedures
  • A cracked tooth
  • Grinding and clenching your teeth

Infection in your tooth causes inflammation in the pulpal tissues. The inflammation causes increased pressure and sensations in the tooth, including pain and 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 spontaneously, or is referred to other teeth, making it hard to determine the exact location, you may have irreversible pulpitis. Regardless of the type of pain you have, you should contact your dental professional as soon as possible for an evaluation. They will take the right measures to treat the inflamed pulp and help stop the pain.

Reversible Pulpitis Treatment

If pulpitis is reversible, the inflammation and discomfort go away when you resolve the source of the problem. 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.

However, if the cause is not treated, the infection will worsen, leading to irreversible damage to the pulp.

Irreversible Pulpitis Treatment

When the condition is irreversible, pulpal inflammation does not go away even after removing the cause. The inflammation causes the pulp tissue to die. With irreversible pulpitis, the pulp is no longer able to heal itself. Your body's immune system breaks down the dead tissue. Still, 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. Besides a root canal, the other option 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.

  1. Follow a good oral care routine that includes cleaning between your teeth daily and twice-daily brushing to protect teeth against cavities and clean teeth thoroughly. Proper oral care also helps preserve your existing fillings that protect your pulp.
  2. Schedule regular visits with your dental professional, so any areas of decay can be identified while still small and far from the pulp.
  3. If you grind your teeth, consider wearing a mouthguard while you sleep to protect your teeth from cracks or breaks.
  4. Reduce or eliminate sweets such as candy and sodas to keep your teeth safe from decay-causing sugar.

Pulpitis can be painful. But, simple treatment may keep your pulpitis as a reversible condition rather than an irreversible one if caught early. With a good oral care routine and help from your dental professional, you can get back to enjoying a pain-free smile.


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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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