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One of the most common reasons to seek emergency dental care is a condition that may sound foreign to you even though the symptoms are all too familiar. Pulpitis, a dental condition characterized by swelling of the pulp inside the tooth, can cause tooth pain and sensitivity. In some cases, the symptoms can be fleeting. In other cases, patients experience severe discomfort, leading them to contact the dentist’s office at all hours in search of relief.

Pulpitis - What a Pain!

(Pixabay / Sammy-Williams)

Our Davis and Weber County dentists have put together a Q&A on pulpitis to help you understand this condition and what you can do if it affects you.

What is pulpitis?

Pulpitis develops when the soft, inner layer of the tooth swells. The swelling may be the result of an injury, tooth grinding, or cavities.

When these soft tissues encased in a hard layer of protection swell, the result is pressure, pain, and sensitivity in the affected tooth. If left untreated, pulpitis can develop into a much more severe infection. It may spread to other parts of the body, including the jaw, the sinus cavities, or even the brain. So, it is essential to visit your dentist if you develop symptoms of pulpitis.

There are two types of pulpitis:

Reversible – Usually the result of only mild inflammation of the dental pulp, reversible pulpitis is often caused by trauma to the tooth. Outside physical pressure resulting from grinding or clenching your teeth, or a hard blow while playing hockey, may be the culprit. This external trauma causes the same internal swelling and symptoms. It can also be caused by small cavities that have not yet infected the pulp. However, because the pulp is still intact and healthy, it can heal once the offending irritant is removed.

Irreversible – Caused by a bacterial infection in the tooth’s pulp, irreversible pulpitis is characterized by severe inflammation, swelling, and intense pain in many cases. Bacteria in the mouth can get inside the tooth anytime that the tooth’s protective outer layer is compromised. Even a small crack in the enamel of a tooth can allow bacteria to invade. Once inside the tooth, the bacteria can take advantage of the soft dental pulp composed of blood vessels, connective tissue, and nerves. The damage caused by this bacterial infection can result in pulp necrosis or death. Once destroyed, these tissues cannot grow back. Necrosis can cause a pocket of pus to develop at the base of the tooth’s root, making it very painful to chew.

If you can’t see it, how is pulpitis diagnosed?

Dentists use many different tools to diagnose pulpitis. Reviewing your symptoms, performing an exam, and taking x-rays can give them a pretty good idea of what is going on inside the tooth. However, your provider may opt to run a few more tests to determine the extent of the problem.

• Tooth Tap – By tapping on your tooth with a lightweight dental tool, the dentist can check for inflammation in each tooth.

• Sensitivity – Exposing your tooth to extremes in temperature will let your dentist know how serious the problem is. Mild, reversible pulpitis will generally cause only transient reactions to hot and cold temperatures. A persistent response may be indicative of a deeply rooted problem.

• Electric Pulp – This test is used to determine the health status of the nerves inside the tooth. Your dentist may use a specialized tool to apply a small electrical charge to the tooth. If the nerve is still functioning, you should be able to feel the pulse.

How can the dentist treat pulpitis?

You can manage the pain associated with pulpitis with over-the-counter non-steroidal anti-inflammatories (NSAIDs) in the short-term. However, these pain medications will not fix the underlying problem. You will need to visit your dentist to determine the cause of the pulpitis and ultimately treat it. The treatment that your dentist recommends will likely be determined by the severity of the infection and swelling.

If you have reversible pulpitis, your dentist will work with you to remove the cause of the swelling and irritation. This treatment may involve wearing a guard at night to relieve grinding pressure from the affected tooth. It may also mean filling any existing cavities before they get too deep.

The treatment for irreversible pulpitis can be more complicated. Systemic antibiotics are not recommended to treat this type of infection, as it does not help repair the nerve or the dead tissue. If the tooth’s nerve and root are damaged beyond repair, your dentist may send you to an endodontist to have a root canal. In this procedure, the endodontist removes the infection and dead tissue. It allows you to keep a tooth in that position. If the damage to the tooth is too far spread, an extraction may be the only choice.

How can I prevent pulpitis from developing?

As with most dental health issues, the best way to prevent pulpitis is to practice good oral hygiene habits. These habits include brushing and flossing regularly, visiting your Utah dentist for regular check-ups, and limiting sugary foods and drinks in your diet. By keeping your teeth healthy and strong and bacteria levels down, you create an environment where bacteria are unlikely to infect your teeth. The best way to prevent problems down the road is to be diligent in caring for yourself and taking care of problems as soon as possible.