Pulpitis may go away on its own. Pulpitis: symptoms and effective treatments

Often, after treatment of pulpitis, the patient discovers to his surprise that the tooth for some reason continues to hurt - there may be pain when pressing on the tooth, biting on it, or it may ache on its own without any external influence. It would seem that there is nothing left to hurt, because the dental nerve has been removed! Why then does the tooth continue to hurt, how long will it last and, most importantly, what to do in such a situation? Let's find out...

Pulpitis of a three-channel tooth is not only an unpleasant phenomenon, but also often very sensitive for the wallet of a person with average income. Let's take a closer look at why treating three canals is more difficult and more expensive than one or two, and also what the current pricing policy is for the treatment of pulpitis in different dental institutions...

Does a dentist need classifications of pulpitis? On the one hand, the first systematization of pulpitis appeared about 90 years ago with the purpose of helping the practitioner in determining the diagnosis based on those meager methods and means that were at hand at that time. With the modern level of equipment in offices, there is probably no point in dividing pulpitis into types and subspecies, but it is quite simple to distinguish it from caries and periodontitis with the help of instruments. Well, each dentist decides for himself whether the classifications of pulpitis used in his work make practical sense for him, or, on the contrary, only complicate life. We’ll talk about these classifications of pulpitis next...

Removing a nerve from a tooth is a very responsible procedure, which, unfortunately, does not always go smoothly for the patient. Improper preparation for working with the “nerve” and medical errors can lead to severe consequences, starting from terrible pain during and after pulp extraction, and ending with bleeding from the tooth and a broken and forgotten instrument in the canal. Why is it generally necessary to remove a nerve from a tooth, how does this happen and what problems may await you along the way - we will talk about this in more detail later...

People who have experienced the symptoms of purulent pulpitis usually never forget the sensations they experienced. And this is due to the fact that due to inflammatory reaction inside the tooth and compression of the neurovascular bundle by purulent exudate, severe pain occurs, which often radiates to various parts of the face, upper or lower jaw, and to the head. It is the absence of a clear localization of pain that creates pain for the dentist at the diagnostic stage. serious problems in determining a pulpitous tooth. Hence there are a lot of ridiculous cases when healthy teeth are drilled out or removed by mistake. Let’s talk about all these points, as well as what a patient should and should not do in such a situation.

Chronic gangrenous pulpitis is associated with the occurrence of irreversible pulp necrosis inside the root canals of the tooth, and it can only be cured by removing the decaying tissue of the neurovascular bundle. The transformation of “living” tissue into pus is a very unpleasant trend, since there is a high risk that all this content will be directed towards the apex of the root and will be released into the tissue surrounding the tooth, where it will form either a fistulous tract through which pus will pour into oral cavity, or “flux” on the gum. Therefore, gangrenous pulpitis is considered a borderline form, when there is only one step left before periodontitis and diffuse purulent inflammation...

Chronic fibrous pulpitis does not cause acute and unbearable pain, creating the effect of imaginary well-being. As a rule, in a short period of time, structural degeneration of the “nerve” inside the tooth ends in gangrene (death) of all or part of the pulp with the formation of pus and its release towards the gums. If we say that this is an undesirable phenomenon, this is to say nothing, since such suppuration is fraught with very dangerous complications. That is why it is so important to “catch” a tooth in the stage of fibrous pulpitis in time in order to have time to do everything necessary to preserve it...

Irresponsible parents of children are still convinced that there is no point in treating carious baby teeth, since they will fall out anyway. When, at the most inopportune moment, for example, on a holiday, a child suddenly begins to complain of an acute toothache, then mothers and fathers have to choose: either to stuff the baby with pills (“chemicals”) for pain relief, or to contact a pediatric dentist for emergency help. You should know that pulpitis in baby teeth develops quickly, often leading to gum suppuration in just a day. In Russia, deaths from complications of pulpitis in children are recorded annually - abscesses, phlegmon, sepsis. Let's look at how pulpitis of baby teeth is treated in modern dental clinics, as well as what complications and medical errors are possible and what this can mean for a child.

To prevent the development of this disease, you need to follow a number of simple recommendations, namely:

• systematic preventive examinations at the dentist: they will help detect caries, so pulpitis will not develop;
• good home hygiene: brushing your teeth at least 2 times a day using a toothbrush and paste.
• Healthy lifestyle and proper nutrition– the key to the health of the entire dental system.

But if you feel pain in your tooth or discomfort when eating cold/hot food, then you should contact your dentist immediately. At the Good Dentist clinic you will receive highly qualified dental care and effectively cure the tooth. In addition, the dentist will help you choose individual means for oral hygiene, will teach proper cleaning teeth, because regular hygiene is one of the factors that will help maintain the health of your teeth.

Causes of pulpitis

Pulpitis develops due to infection. Untreated dental caries is the main cause of this disease. The carious cavity contains bacteria and microorganisms that gradually destroy the tooth. And when the destruction reaches the nerve, pain occurs.

Stages of pulpitis

The disease is characterized at different stages and its manifestations and intensity pain.

Purulent pulpitis

This acute stage manifests itself as unbearable, constantly throbbing pain. It intensifies in evening time, sometimes patients wake up at night from a pain attack. Pain occurs not only in the area of ​​the affected tooth, but also radiates to the jaw, ear, and temple. Helps reduce pain cold water, but it is important to remember that easing the symptoms of the disease is not a cure. It is necessary to eliminate the cause – inflammation. If this is not done, necrotic decay of the nerve will begin.

Acute pulpitis

Acute toothache that occurs when eating hot/cold food or when a stream of air hits the tooth - main feature such pulpitis. The pain goes away after the irritant is removed. Sometimes the pain subsides for a long time.

But since the pain appears, it means that there is serious inflammation in the tooth, which arose due to caries. Microorganisms entered the nerve and pain appeared. At this point, the disease is characterized by severe pain with throbbing. It occurs in the evening and at night, maybe only a couple of minutes or even persists throughout the day.

Chronic pulpitis (gangrenous)

This form appears when pulpitis is already advanced, and no treatment has been carried out for a long time. Under the influence of external stimuli, pain appears, as soon as the stimuli are eliminated, it goes away.

The most dangerous thing about gangrenous pulpitis is that the pain can occur suddenly. It is characterized as a strong pulsation. Sometimes there is a “dull” soreness. Often, at the time of treatment of this form, there is some pain and bleeding from the tooth.

Sometimes the disease can occur without symptoms. For example, when there is no obvious carious cavity, therefore, irritants do not enter the tooth and do not cause pain.

Types of pulpitis

The dentist’s treatment tactics will depend on which tooth this disease occurs on.

Front tooth

The symptoms will be the same as on chewing teeth. It is not difficult to diagnose such pulpitis. In addition to the main clinical picture The tooth pulp will be visible through the enamel. Pain of unclear localization often occurs: the patient points to a completely different tooth. In addition to the main treatment, painkillers are prescribed, and when filling the crown of the tooth, the aesthetics are carefully restored.

Pulpitis of wisdom tooth

Pulpitis develops on this tooth for the same reasons as on other teeth and clinical manifestations the same. Often it is not possible to treat “figure eights”, since they are located very far away, have a complex anatomy, or even grow “into the cheek”. Therefore, in such a situation, tooth extraction is prescribed.

What happens if pulpitis is not cured?

Any disease cannot go away on its own unless the cause is eliminated. Tooth pulpitis is no exception. The infection in the tooth will only spread, the nerve will die, and microorganisms will spread beyond the root of the tooth into the bone tissue - into the periodontium. If pulpitis is not cured, periodontitis will occur.

Complications can also include deterioration of the condition of the tooth, through the transition of one stage of the disease to another: purulent form into gangrenous or nerve necrosis. If you do not pay attention to the first symptoms and neglect the tooth, the treatment will be much more expensive, and sometimes even tooth extraction will be required.

Patients often turn to the doctor late, since pulpitis is asymptomatic. This is the danger of this disease: there are no worries, but inflammatory process it goes and affects more and more tissues. Or a slight pain occurs, then quickly passes, and the patient thinks that everything is fine with the tooth. It is important not to forget that if pain in a tooth ever occurs, there is a reason to consult a dentist.

Methods and methods for treating pulpitis (how is tooth pulpitis treated?)

Many patients have the opinion that treatment of pulpitis is very painful, but in fact, modern dentistry has done everything to make the treatment comfortable. In any case, the treatment method and the number of visits are determined only by the dentist after examination. Based on objective data, x-ray and medical history data, a decision is made on the choice of treatment tactics.

Treatment of pulpitis in one visit

Such treatment is possible if the tooth has a minor carious cavity, there is no extensive damage, and the infection has spread slightly. Based on these data, and also if the patient agrees to carry out treatment immediately, the doctor begins his manipulations.

Treatment in two visits

If the pulpitis has a complex shape, or the tooth is severely damaged by caries, then two or more visits are prescribed. Then all non-viable tooth tissue is removed, the nerve is removed, the canal is washed and treated. The doctor will tell you more about these manipulations during the consultation and will allocate time for subsequent visits. Each visit, the doctor observes the tooth and, if necessary, can change the number of visits and the scheme of treatment procedures.

Surgical method for treating pulpitis

It involves removing the nerve from the tooth, and, if conditions exist, the doctor preserves the root pulp. If the nerve is completely removed, then the canals are cleaned and sealed. If the nerve is partially removed, a filling is placed on the tooth and its anatomical shape is restored.

Laser treatment of pulpitis

This method appeared in dentistry relatively recently. It is characterized by its painlessness. It is necessary to cauterize the nerve with a special laser without removing it. This technique allows you to save the nerve. First, a temporary filling is placed on the tooth, the doctor observes the tooth for a certain time, if there have been no relapses, the treatment is completed - a permanent filling.

Biological method of treating pulpitis (treatment of pulpitis without removing the nerve)

This method is conservative and involves preserving the pulp. It is recommended when the inflammation is not severe, or, for example, with a reversible form of pulpitis. Special medications are used.

How long does treatment take?

All cases are strictly individual and depend on the initial clinical picture. But there are two schemes: treatment in one visit and in two. In the latter case, the tooth is first covered with a temporary filling, and after a certain time the doctor completes the treatment.

What to do after treating pulpitis?

The doctor will tell you everything that needs to be done after treatment. Recommendations include avoiding too cold/hot food and eating after a while. In complex clinical situations, absence of physical activity, peace.

Treatment of pulpitis during pregnancy

Pregnancy is physiological state when increased attention to the health of mother and child is required. But when pain occurs, it is contraindicated to endure it or self-medicate. This can lead to serious complications affecting not only the oral cavity, but also the pregnant woman’s body as a whole.

Under no circumstances should treatment be delayed, as this can lead to serious consequences. During the consultation, the dentist will help you choose a safe treatment method that will not harm mother and baby. The method of pain relief is also carefully selected. In addition, X-ray examinations are not prescribed (except for complex clinical cases).

At the initial consultation, you must tell the doctor about the duration of your pregnancy and, if any, any health conditions (for example, the presence of allergic reactions or heart and vascular diseases). After the examination, the dentist will make a diagnosis and tell you when to start treatment.

Most full information The dentist will advise you on the condition of your teeth and the need for treatment. Frequently asked questions during the consultation: is it painful to remove a nerve, is it possible to do without removing it, when does a tooth need to be removed, does the treatment take place in one visit, what is the cost of treatment, etc. Our specialists will tell you in detail about everything related to dental treatment.

As a rule, we do not think about the fact that inside each tooth there are nerve endings and blood vessels. However, acute inflammation can remind you of this at any time. Pulpitis is a pathology that everyone encounters at least once in their lives. The good news is that modern dentistry has proven treatment methods that can solve the problem quickly and effectively.

But maybe everything is not so scary and you can just endure the pain? After all, sometimes you really don’t want to go to the dentist! Let's figure out what processes occur inside the tooth during pulpitis and why a visit to the doctor should not be postponed.

General characteristics of the disease

Pulpitis is an inflammation of the dental nerve (pulp), which is located in the dental cavity and root canals. The pulp is extremely sensitive, and if a tooth is deeply damaged by caries, there is a crack in it, or a filling has fallen out of it, then the likelihood of developing pulpitis is quite high. Inflammation can also occur during treatment or preparation for dental surgery if the doctor is not careful enough. In rare cases, a previous infectious disease becomes a provoking factor.

Pain can occur when the tooth is exposed to cold or heat, sour foods, alcohol, or sugar. If you see a doctor right away, the inflammation can be suppressed. However, patients often try to relieve pain with analgesics, wasting precious time. As a result, nerve damage becomes irreversible and the pulp must be removed. The danger of pulpitis is that without treatment, inflammation can spread to the tooth root, which increases the risk of tooth loss. Sometimes the pain goes away spontaneously, but this is not an indicator of recovery. This situation may indicate that the nerve is irreversibly damaged by harmful bacteria and a purulent mass begins to form in the tooth cavity. The latter, if it gets into the base of the tooth root, can cause gumboil - a purulent lesion of the jaw.

If the inflammatory process gives you discomfort already for a long time, you should not delay going to the doctor: removing the nerve in time will help avoid complications. Of course there is psychological factor: many patients do not like going to the dentist, they are afraid of pain, and do not want to waste time and money. It is important to make a sound decision here so as not to aggravate the situation, especially since modern dentistry is accessible and practically painless.

How to treat pulpitis: modern approaches and methods

Treatment of pulpitis involves eliminating inflammation. This can be done in two ways: either by performing healing and restorative procedures on the pulp, or by completely removing it. The choice of doctor will depend on the condition of the pulp and the stage of inflammation.

Conservative treatment of pulpitis (biological method)

If the patient consults a doctor immediately after the onset of acute pain, it is possible to stop the inflammation while preserving the nerve. The pulp is exposed and processed antibacterial drug, a microbandage with calcium hydroxide is applied on top and the hole is closed with a temporary filling. After a few days, an x-ray is taken, the condition of the pulp is assessed and, if the inflammation has stopped, a permanent filling is placed. It must be borne in mind that this method is not always applicable and requires a highly qualified doctor, so conservative treatment will not be offered to you in every dental clinic.

Surgical treatment of pulpitis

A traditional method that has different implementation options depending on the specific case and the age of the patient. Consists of complete or partial extraction of pulp from the tooth cavity.

Extirpation. Used in the vast majority of cases. Represents complete removal pulp.

1. Vital. Under anesthesia, living pulp tissue is removed. First, the dental tissue affected by caries is removed, treated with an antiseptic, then the infected nerve is removed and the cavity is filled. The procedure requires just one visit to the dentist; it is universal for any form of pulpitis, but is not applicable for patients with allergies to anesthetics.
2. Devital. If it is impossible to carry out vital extirpation, the pulp is exposed to paste-like toxic substances (for example, arsenic) so that it can then be painlessly removed. The paste is applied for 24–48 hours, if the patient can come for a second appointment quickly enough, or for up to 14 days - in this case, mildly acting formulations are used. The cavity is closed with a temporary filling until the next procedure. At the second appointment, the doctor removes the dead pulp, cleans the canals and places a permanent filling. For purulent pulpitis or tissue necrosis, the method is not used.

Amputation. In this case, only the coronal part of the pulp is removed, the root part remains in place. For teeth with one root, amputation is not suitable, since in this case it is almost impossible to isolate individual elements of the pulp. Amputation is usually prescribed for acute pulpitis or accidental mechanical damage to a tooth.

1. Vital. The necessary part of the nerve is amputated under anesthesia in one procedure. The method is indicated for patients under the age of 45 with healthy periodontium.
2. Devital. After exposing the pulp to a toxic paste, the dead area is removed, and the healthy one is deliberately mummified, for example, with an antiseptic paste based on zinc oxide-eugenol, so that the infection cannot develop again. Devital amputation is used in difficult cases when it is impossible to reach the desired area of ​​the pulp. The modern arsenal of dentists includes flexible nickel and titanium instruments. With their help, you can treat even the most curved canals, which eliminates the need for complex techniques.

The use of arsenic for the treatment of pulpitis was proposed only at the end of the 19th century. Before this, the inflamed pulp was destroyed with hot oil or burned with a hot iron. These methods were used by ancient Greek and ancient Egyptian dentists.

Stages of pulpitis treatment

Let us dwell in more detail on the extirpation method - as the most common and long-lasting. The procedure requires two to three visits to the doctor, depending on the number of roots of the diseased tooth.

1. Removal of tissue affected by caries. The tooth is cleaned, opened and the pulp chamber is exposed. With the devital treatment option, arsenic is placed in the tooth cavity, a temporary filling is placed and a date is set. next appointment. If the pulp can be removed immediately, treatment begins with the next stage.
2. Pulp removal. A special pulp extractor is used.
3. X-ray. An image is necessary to determine the length and shape of the canals.
4. Cleaning the canals and the tooth in general. This stage is necessary to exclude new inflammation.
5. Installation of a seal. First, the canals are filled, then the coronal part.

The last stage can be completed in two visits. In some cases, anti-inflammatory drug therapy is prescribed.

After installing a filling, so-called post-filling pain when biting is possible. It is considered normal unless it lasts more than a week. Some dentists consider it unacceptable. She shouldn't be strong anyway. If you experience serious discomfort, you should further consult your doctor.

Features of treatment of different forms of dental nerve damage

In the modern classification, pulpitis is divided into acute and chronic. In each of the two forms it is easy to identify characteristic stages.

Acute pulpitis. One of the most common complications of deep caries. It manifests itself as severe pain, which can intensify with pressure on the tooth, exposure to heat or cold, sour or spicy food. Attacks of pain often occur at night. In children, due to the peculiarities of the jaw structure, acute pulpitis practically does not occur; in adulthood, men and women are equally susceptible to it. The disease occurs in two stages, after which, in the absence of treatment, it becomes chronic.

1. Focal. initial stage, lasts up to 2 days. The inflammatory focus is located close to the carious cavity. The pain is sharp, “shooting” in nature, attacks last for 10–30 minutes with breaks of several hours. At this stage, it is not difficult to identify a diseased tooth, since the pain is point-like.
2. Diffuse. The second stage, which occurs when the coronal and root parts of the pulp are damaged. The pain is diffuse, radiating to different parts of the jaw, the temporal and occipital parts of the head, and cheekbones. The attacks are longer, and the pauses between them are only 30–40 minutes. Acute diffuse pulpitis lasts no more than 2 weeks. If during this time the patient does not see a doctor, the disease becomes chronic.

Chronic pulpitis. It can last, without disturbing the patient too much, for up to several years. Toothache significantly dulls, you can get used to it, although chewing is difficult, and with external influences the pain intensifies. Exacerbations are possible from time to time. The treatment method depends on the type of chronic pulpitis.

1. Fibrous. It is characterized by the presence of a deep carious cavity, which does not always reach the pulp chamber. The pain is mild, intensifies only when pressing on the tooth, and blood appears from time to time.
2. Gangrenous. If an infection is added to fibrous pulpitis, the pulp atrophies, becomes dirty gray, the pain intensifies, and the carious cavity expands. There is a smell from the mouth.
3. Hypertrophic. It is characterized by the fusion of a carious cavity with a tooth cavity and the formation of a polyp from granulation tissue, which bleeds and hurts when pressed. But there is usually no pain.
4. Exacerbation of chronic pulpitis. Simultaneous manifestation of signs of acute and chronic pulpitis. The patient experiences attacks of sharp pain, which intensifies when pressing on the tooth. Possible destruction of bone tissue and periodontal infection.

Most often, patients with fibrous chronic pulpitis turn to dentists. Gangrenous is less common, and hypertrophic is in last place. If pulpitis has become chronic, surgical treatment is required in 90% of cases. Acute forms can also be treated with conservative therapy. In any case, you will need a reliable clinic, where they will not only expertly carry out the procedure for restoring or removing the pulp, but also install a high-quality permanent filling. Losing a filling can cause damage and pulpitis to adjacent teeth.

How to choose a reliable dental clinic?

Many patients, under the influence of acute pain, choose a clinic spontaneously, and then continue to go there for years, without thinking about the quality of the services provided. Of course, there is no time to search and compare data in such a situation. We asked a representative of the Dental Association to comment on this problem:

"Of course, if you have sharp pain, you can go to your nearest dentist, this is a natural solution. However, try to pay attention to the following details:

• Dialogue with the doctor - the dentist should ask you in detail about your feelings, check the tooth’s reaction to various influences. Next, the patient is informed about possible treatment methods.
• A clear treatment plan - after talking with your doctor, you should understand how many procedures will be required, at what interval and why.
• The possibility of an unscheduled appointment - in the event of a sudden complication, you should be seen at a time convenient for you.

If you don’t like something, you can go through the next stages of treatment in another clinic that you choose already in calm state when the pain goes away.

Our Association has opened a hotline for dental treatment issues. 24 hours a day, seven days a week, specialists from various fields of dentistry will consult you free of charge by phone, tell you about a possible treatment plan, and suggest a particular clinic. When receiving treatment from the Association, guarantees are given for materials and services provided, and competitive prices are offered. Our dentists have extensive experience in therapy and surgery various forms and stages of pulpitis, and you can be sure that after treatment the tooth will not cause you any trouble.”

P.S. The site presents prices for treatment on an all-inclusive basis, which will allow you to avoid unexpected expenses during treatment.

Aching and “shooting” toothaches, discomfort from cold and hot - all these signs indicate one thing - acute pulpitis. This term is used by dentists to refer to inflammation of the pulp – the neurovascular tissue, which is popularly called simply the “dental nerve”.

Acute pulpitis never goes away on its own. This disease is quite insidious: it can “subside”, and then suddenly make itself felt with unbearable pain. Inflammation can occur in several forms and with different symptoms. How they differ, how to diagnose and treat them - we will answer these and other questions in our article.

Symptoms and diagnosis

Patients with acute pulpitis have two main complaints:

• Severe paroxysmal pain that occurs spontaneously without irritants and intensifies at night. Over time, they become pulsating, shooting, and acquire a permanent character.
• Painful sensations when drinking cold and hot drinks and food. The unpleasant reaction lasts for 10-20 minutes after the irritant is removed.

Differential diagnosis

The signs of acute pulpitis are similar to the symptoms of other diseases. For example, with caries there is also a painful reaction to temperature stimuli, but it goes away with the elimination of the stimulus itself.

Severe pain is also typical with irritation trigeminal nerve, but with pulpitis at night they become unbearable, and with trigeminal neuralgia, on the contrary, they subside.

Pulpitis is distinguished from exacerbation of chronic periodontitis in two ways - by tapping on the crown and biting on the tooth. Unlike periodontitis, when neurovascular tissue is affected, there is no pain.

Research methods

1. Study of anamnesis. All patient complaints must be listened to and analyzed.
2. Visual inspection. Special attention is given to previously filled crowns and those whose gums around them are inflamed.
3. Temperature test. Cold and hot liquid is dripped into the area of ​​the tooth suspected of acute pulpitis.
4. Probing. After “opening” the diseased crown and removing the affected tissue with a drill, the dentist examines the cavity with a probe and determines its depth and degree of inflammation.
5. X-ray examination. The image shows the extent of the damage and shows the structural features of the root canals, which the dentist needs to fill with medicine.
6. Electroodontodiagnostics. Studying the response to current of different strengths. The greater the current strength to which the nervous tissue reacts, the larger the source of inflammation and the deeper it is located.

Pulpitis on x-ray

Forms

Depending on the cause of the disease, there are three main forms of pulpitis - infectious, traumatic, concremental.

There is also a classification according to the stage of development of the inflammatory process, based on ICD 10 of the World Health Organization:

• deep caries – initial stage;
• acute focal (serous);
• acute diffuse (purulent);
• chronic fibrous;
• chronic gangrenous;
• chronic hyperplastic.

Infectious

Most often it occurs due to untreated caries. Pathogenic bacteria from the carious cavity enter the pulp, infecting it. Sometimes microbes penetrate into it from the periodontal side. This type of infectious pulpitis is called retrograde.

Traumatic

Inflammation is caused by trauma to dental tissues - a chip, crack or fracture of the crown or root. It's often to blame poor quality treatment caries: prolonged drilling without cooling causes burns to the pulp. Thus, pulpitis of traumatic origin can begin immediately from the acute stage.

Concrete

The reason is the appearance of hard calcareous deposits in the canals - denticles, or as it is also called - “dental pearls” or pulp stones. Such neoplasms often lead to dystrophy of the neurovascular tissue with the subsequent development of inflammatory processes.

Focal (serous)

First stage acute course diseases. The infection affects a certain area of ​​tissue, the rest of the pulp remains healthy. The immune system responds to the inflammatory process: serous fluid accumulates in the canals, which begins to compress the nerves. Attacks of pain last no more than twenty minutes, and the stage itself lasts two days. The patient can clearly point out the disturbing tooth.

Diffuse (purulent)

Untreated serous pulpitis develops into diffuse pulpitis. All neurovascular tissues become inflamed, and purulent contents accumulate in the canals. It compresses the nerve tissue, this process is accompanied by unbearable pain that does not subside for hours.

In the presence of purulent processes, it is very difficult to identify a diseased tooth, since for most people the pain “radiates” to different parts of the jaw and even the head: patients complain of pain in the ear, cheeks, throat, etc. Diffuse inflammation can last from two days to two weeks.

Complications

Without treatment, the acute form inevitably turns into a chronic form, and then into an exacerbation of chronic pulpitis. The infection progresses, the internal neurovascular tissue gradually “dies”.

Chronic fibrotic

Severe pain stops and becomes aching. They are provoked by temperature stimuli - hot food, cold air. Although some patients have no symptoms, they do not complain of unpleasant symptoms. The chronic fibrotic process is characterized by the presence of a deep carious cavity: sometimes it reaches the pulp itself - bleeding and painful. There is no reaction to tapping on the crown.

Chronic gangrenous

It is characterized by the appearance of a putrid odor from the mouth, positive aching pain, aggravated by the consumption of hot food and drinks. Neurovascular bundle begins to atrophy and acquires a dirty gray color.

Chronic hypertrophic

The carious cavity is completely connected to the tooth cavity, the affected pulp grows and occupies the entire intradental space. Patients experience pain when chewing, bleeding occurs, and severe pain, characteristic of the acute stage of pulpitis.

Exacerbation of chronic pulpitis

In the end, all the symptoms of the acute form join the manifestations of the chronic form. Bone the roots begin to dissolve. Gradually, this leads to the development of periodontitis - inflammation of the tissue between the root and the jaw bone.

In the most advanced cases, pulpitis is fraught with serious complications that threaten human health and even life. Pus from the dental canals can enter the blood vessels and cause purulent inflammation sinuses, meningitis and sepsis, the appearance of abscesses of the head organs.

Acute pulpitis of milk teeth

Temporary teeth differ in structure from permanent teeth, so the inflammatory process in them develops with different dynamics. The peculiarities are that the child’s root tips may not yet have formed or may already have dissolved before the change in bite.

Stages of acute pulpitis of temporary teeth:

Serous.

It appears already at the stage of average caries, since the permeability of dentin in children is higher and the infection spreads faster. Focal forms immediately become diffuse, and in a short time the entire pulp is covered by pathological processes.

Very quickly becomes chronic. It is dangerous because the purulent contents leave the canals almost unhindered, affect periodontal tissue and can spread to the lymph nodes closest to the diseased area.

Inflammation of the pulp of the front teeth can be observed in children from the age of two, and in the back teeth - from the age of three to seven.

At the acute stage, children complain of pain, an unpleasant reaction to cold and hot, chew on one side, and to relieve pain they lie on the side where the diseased tooth is located. Their cheeks may swell and their submandibular lymph nodes may become enlarged. Chronic inflammation It is practically asymptomatic; the disease makes itself felt during exacerbation.

It is extremely important to cure the patient in time baby tooth so that the infection does not affect the rudiments of the permanent. If the parents brought the child to the doctor for early stage pulpitis, the dentist will try to save the tooth conservative method, keeping the pulp alive. Otherwise it is carried out surgical treatment.

Treatment methods

Dentists use two main methods: conservative and surgical. In the first case, they try to preserve the pulp, in the second, it is removed. The course of treatment involves 2-3 visits to the doctor.

Conservative

It is used extremely rarely, since it is effective only for focal acute pulpitis or fibrous chronic pulpitis, and patients usually consult a doctor in more advanced cases.

Methods of conservative treatment:

Biological.

The pulp is preserved in both the crown and the canals. To eliminate the pathological process, a therapeutic pad is placed on the bottom of the tooth cavity, physiotherapy is prescribed - depophoresis, helium-neon laser treatment, etc.

Vital amputation.

Conditional conservative therapy, in which the pulp in the coronal part is removed, while in the canals it is preserved biologically. Suitable for multi-rooted teeth only.

Operational

Most often, pulpitis is treated precisely surgically– that is, the pulp is completely removed, the root canals are disinfected and a filling is placed. This is cheaper and simpler, since the doctor does not have to carry out complex diagnostics by examining the lesion of the vascular tissue.

The diseased tooth is “opened”, the cavity and canals are filled with devitalizing paste. In a few days it kills nerve tissue, after which the canals are processed and sealed. To monitor the result of treatment in mandatory X-rays are performed.

It is worth noting that in modern dentistry they no longer use arsenic-based paste; preference is given to its safer analogues.

Note that treatment homeopathic medicines and traditional medicine will not give any positive results.

According to official statistics, in 60-70% of cases, treatment of acute pulpitis is carried out poorly and with complications leading to tooth loss. To avoid such a fate, we recommend choosing a good clinic on our website, where the removal of the dental nerve will take place without consequences or injuries.