What is pulpitis? Symptoms and signs of pulpitis. Treatment and prevention of pulpitis

Most often, for help to the dentist, we apply already after the illness will make itself felt by acute pain. Most often pulpitis occurs as a complication in caries. If you do not examine your teeth in time and solve this problem, then you need to treat not caries, but pulpitis. If you also run it, you will probably have to remove the sick tooth.

What is pulpitis? Photo of

The tooth consists of dentin, enamel and a layer of soft tissues located beneath them. Pulpitis is an inflammation of these tissues. This is a dangerous problem, which is fraught with tooth loss. Moreover, this disease can lead to a violation of the structure of the bones of the jaw, stomach and intestinal diseases and even cause a fatal outcome.

Soft tissue damage

Causes of Teeth pulpitis

• The most common cause of this problem is caries started. Beginning as a lesion of the upper part of the tooth enamel, the caries quickly spreads into the deeper tissues. When the lesion reaches the soft tissues, pulpitis
• can occur. Pathogenic bacteria and microorganisms quickly destroy the enamel and move inside the tooth. If you do not provide medical help in time, cariogenic microorganisms will begin their inflammatory process in the
• pulp. There are other reasons for this problem. One of them is insufficient cleaning of tissues by a dentist from carious bacteria when installing a seal. In this case, the bacteria will continue their harmful effects and, if they fall into the pulp, cause it to become inflamed.
• To inflammation of the pulp can cause the dental cavity to dry out before sealing, thermal burn during drilling of the affected tissues, due to injuries, temperature and other irritants, blood contamination and periodontal inflammation

IMPORTANT: The pulp is an important part of the tooth. It is she who helps us feel cold, hot and pressure on the tooth. Without it, the tooth becomes "dead."Unfortunately, inflammation of soft tissues is often treated with the removal of pulp. Until today it could not be restored. But, thanks to Dr. Misako Nakashima from the National Center for Geriatrics and Gerontology in Obu( Japan), shortly soft tissue of the tooth can be restored with the help of stem cells. The first experiments were successful.

Symptoms and signs of pulpitis

The dentist will help with problems with teeth

This disease has both acute and chronic forms. A characteristic cause of acute form of pulpitis is paroxysmal pain. Such pain can have a cutting and shooting character. She brings severe torment, which can be eliminated only with the help of strong painkillers.

Pain can be provoked by external stimuli( cold and hot food), but unlike caries, it does not subside even after removal of the stimulus.

Pain can be projected onto a single tooth or radiated along the branches of the nerve. She can give in the temple, ear and nape( lower teeth) or in the cheekbones and the area of ​​the eyebrow( upper teeth).

IMPORTANT: Some forms of pulpitis pass without pain. Diagnosis of such a dental disease is possible only by a specialist after examination of the oral cavity.

What types of pulpitis exist? Types of pulpitis

• At the moment there are several classifications of this disease. Not all of them are used by practicing dentists. Most often they classify pulpitis by origin.
• Infectious pulpitis. It is characterized by inflammation of the nerve channel of the tooth as a result of the action of pathogenic microorganisms. In 90% of cases, this problem develops when bacteria enter the carious cavity through the dentinal tubules into the interior of the
• pulp. Rarely, bacteria enter the pulp through the opening in the root( retrograde pulpitis).
• Even more rarely in dental practice, hematogenous pulpitis occurs. It is characterized by the ingress of pathogenic microorganisms into the pulp through the blood( hematogenous pulpitis)
• In a healthy tooth, the pulp is reliably protected behind hard tissues and enamel. When the tooth is injured, the pulp chamber can be opened. Bacteria from the oral cavity, getting into an easily accessible place, lead to inflammation of the pulp( traumatic pulpitis)

IMPORTANT: Unfortunately, this type of problem is often not caused by the patient, but through the fault of the dentist. If the tooth is treated incorrectly, it can overheat the tooth cavity or insufficiently remove the affected tissue. That eventually lead to the emergence of traumatic pulpitis.

Non-infectious origin has concremental pulpitis. It causes metabolic disturbances in the neurovascular bundle. Such violations are most often caused by the formations compressing the vessels. This leads to a deterioration in blood flow and formation of edema. Which, in turn, can flow into the inflammation.

Diseases of the tooth

• In 1968, the classification of pulpitis, developed by the doctor of medical sciences Platonov, was offered to practicing dentists. This classification has its drawbacks, but it is still used by specialists of
• . Professor suggested three types of pulpitis: acute, chronic and exacerbation of chronic pulpitis. And in the acute variety of this disease Platonov identified two varieties: focal and diffuse. In the first case, the patient can accurately determine the place of pain, and in the second, it flows from the tooth to the ear, the eye and other places of the head. What often makes it difficult to find a sick tooth
• The World Health Organization also introduced its classification of this disease. It was called ICD-10.

This classification distinguishes:

• initial pulpitis or pulpal hyperemia is translated as "deep caries"( K04.00)
• acute pulpitis - means "acute focal"( K04.01)
• purulent pulpitis, pulpal abscess - characterizes acute diffuse pulpitis and t.(К04.02 - К04.09)

IMPORTANT: Many dentists using this classification, in order not to "complicate" their lives put the encoding K04.00.Which means simply the presence of a disease.

Purulent pulpitis, diagnosis

If acute inflammation of the pulp is accompanied by the presence of purulent foci, then this disease is called purulent pulpitis. A patient suffering from such a disease can have severe attacks of toothache. It often has a pulsating character and can give to different parts of the head. With this kind of pulpitis, body temperature often rises to 39 degrees.

The affected tooth can react sharply to sweet, sour, cold and hot. Pain often intensifies toward evening. Near the affected tooth may appear swelling of the mucosa.

pulp injury

• In order to ascertain the presence of an inflammatory process, the dentist must prescribe the X-ray of the tooth.
• Modern dentistry can offer two types of purulent pulpitis treatment: vital and devital. In the first case, removal of the pulp and filling of the diseased tooth is carried out without the prior killing of the nerve. Usually at one time a patient can completely get rid of his problem and get a sealed tooth
• The devital method involves killing a nerve with a special paste( for example, "Devit") and setting a temporary seal. On a second visit, the dentist removes the temporary seal and the affected and pulp. He then cleanses the nerve channels and seals them
• Both these ways of treating a purulent pulpitis have their positive and negative points. Therefore, the decision on what method of treatment should be used on the shoulders of a specialist after his examination of the oral cavity of

IMPORTANT: Success in the treatment of this disease depends not only on the professionalism of the dentist, but also on the implementation of those rules that the specialist will establish after all necessary actions with the affectedtooth.

Acute pulpitis, diagnosis

Penetration of infection in soft tissues

• Acute inflammatory response of tooth pulp to external stimuli is called acute pulpitis. Thus stimuli can have both infectious, and other character. Infection can enter the tissues of the pulp through the carious cavity. It can cause foci of periodontitis, periodontitis, sinusitis and other infectious diseases. Not infrequently, the acute phase of this disease occurs when the injuries of the tooth
• Acute pulpitis is characterized by severe toothache. It can arise from the ingestion of food particles into a tooth defect, with the use of hot and cold food, etc. Acute pulpitis can flow into a chronic or purulent
• Treatment of this disease depends on the stage and species. Methods of treatment are divided into conservative and surgical. In the first case, the inflammation is eliminated without eliminating the pulp. In this case, the patient is prescribed special pastes, proteolytic enzymes, physiotherapy treatment, calcium hydroxide-based preparations, temporary or permanent filling
• Surgical treatments for such a variety of pulpitis suggest full or partial removal of the affected pulp. As with purulent pulpitis, the vital and devial ​​amputation is used to remove pulp

Pulpitis in children

Health of children's teeth

• The described disease can occur in both adults and children. Symptoms of such a dental disease are similar to the symptoms of pulpitis in adults. Damage to the pulp can lead to pain or to be asymptomatic. Often such a disease provokes a fever, inflammation of the lymph nodes and edema in the place of the affected tooth.
• It is very difficult to diagnose pulpitis in young children because they can not always convey their feelings to adults. In children up to three years old, the risk of pulpitis spreads to the front teeth. In 9-year-old children lesions of
• incisors are more common. To diagnose this problem, the same methods are often used as for the diagnosis of this problem in adults: visual examination, X-ray examination and palpation. Since children usually behave with such procedures uneasily, they may need tranquilizers. It can be "Sibazon" and "Mebikar"
• Children's pulpitis is treated in several ways. Most often the pulp is covered with a special anti-inflammatory therapeutic paste. To treat this problem, partial or complete removal of the pulp may be required. In the first case, the affected area is removed and the wound is closed with a special restorative material. With devital extirpation, the pulp is completely removed

Pulpit of teeth with unformed roots

• Unfortunately, it is still possible to hear such an opinion that baby teeth can not be treated. Why, if they fall over time? Of course, milk teeth need to be treated. Whether caries, and especially pulpitis
• The idea that the milk teeth should not be treated is very dangerous. Often, the child's pulpitis develops precisely because the parents "decided" that the temporary tooth affected by caries will fall out and with it the
• problem will be eliminated. Dairy temporary teeth, affected by pulpitis, hurt just like molars. And cause not less torments than permanent teeth. It is not always possible to remove this problem with various sedatives due to the age of the child.

IMPORTANT: In the medical literature, cases are described where, due to pulpitis of the milk tooth, blood was contaminated and the child died. Complications of this disease due to weak child immunity can carry very serious problems. Not infrequently from the first pains to a strong edema of the face passed a few hours.

• Teeth with unformed roots are more prone to chronic pulpitis. As for the acute form of this disease, it is divided into a serous and purulent variety of pulpitis
• . In the serous variety of this disease, the inflammatory process blocks the access of oxygen to the pulp. As a result, serous fluid is formed and fills the canal channels. After 5-6 hours, the serous pulpitis passes into the purulent stage of

IMPORTANT: Pulpitis of the milk tooth can affect the rudiment of the permanent tooth. Therefore, at the first signs of this problem the child needs to urgently consult a dentist.

• In municipal dental offices, most often the doctor chooses a devital way to solve the problem. He puts a special paste on the opened "nerve", which leads to his death of
• . At the next visit to the dental office, a special resorcinol-formalin mixture is pumped into the temporal tooth cavity of the pulpitis infected( which, by the way, is banned in a number of countries because of its harmful effect on the body).The seal on such a tooth is placed only on 3-4 visits to the dentist
• . In the paid dental offices, more modern methods of treating pulpitis in children are used. From the teeth with unformed roots, the affected pulp is removed. The cavity is subjected to sterile processing and pumped into it with a special paste with anti-inflammatory effect( for example, "Magipex")

How to treat pulpitis medically?

The dentist

• The traditional methods of treatment of this dental disease are described above. But, dentistry does not stand still and every year offers patients new methods and tools for treatment. And the most up-to-date of them is the effect on the affected pulp by laser
• Laser is most often used in the treatment of focal pulpitis. The laser has an anti-inflammatory, analgesic and regenerative effect. After such irradiation, the pain begins to gradually disappear and after a day should disappear completely. Laser exposure activates metabolic processes and triggers the regeneration of pulp cells
• No less popular is a modern method of treating pulpitis as depophoresis. With this method, you can remove inflammation in the canals of the tooth and prevent complications. Using an electric field, pathogenic microorganisms are destroyed in the infected tooth. At the same time, copper-calcium hydroxide is fed into the channels, which stimulates the formation of bone tissue.
• The solution of the problem of a diseased tooth with the help of modern techniques is an order of magnitude higher than traditional methods of treatment. But, first, many procedures are painless. And, secondly, modern methods of treating pulpitis allow you to gain time. In a few hours you can achieve the result, which with traditional methods can be achieved in a few days.

Errors in the treatment of pulpitis

Fear of tooth treatment

• Errors in this disease can occur at different stages of its treatment. A dentist can diagnose an incorrect diagnosis or choose an unsuitable method of treatment.
• An incorrectly diagnosed diagnosis with such a dental disease occurs quite often. The thing is that chronic fibrous pulpitis is similar to ordinary caries. And determined the disease as a caries dentist chooses the wrong method of treatment. At the same time, he can accidentally open the horn of the pulp or leave the opened pulp unnoticed by
• . It is very important to correctly determine the type of pulpitis. In the tooth with gangrenous pulp can not lay arsenic paste. This can lead to arsenic periodontitis. And the presence of such a paste on the perforation of the carious cavity in the region of the neck of the tooth can lead to osteomyelitis with the rejection of sequesters for a long time after tooth extraction.
• . Also, often chronic fibrotic pulpitis is mistakenly diagnosed as acute focal. And choose the wrong method of its treatment

Complications of pulpitis

Complication of this disease is the spread of infection beyond the root canal. What leads to apical periodontitis, osteomyelitis of the jaw, abscess and phlegmon of the maxillofacial region.

Also complications of this problem can cause unqualified dentist actions during treatment. The most common of these is the breaking of the tool and leaving it in the canals of the tooth. To extract it, additional operations may be required.

Another complication during the treatment of pulpitis is poor-quality sealing. If the material extends beyond the apical opening, this can cause a negative reaction of the tissue to such interference.

What is the danger of pulpitis in pregnancy?

Dental treatment during pregnancy

• Pulpitis is susceptible to all and pregnant women are not exceptions. However, many of them believe that it is impossible to treat this tooth disease during pregnancy. In their opinion, this can harm a child. This is not true. More truly, not absolutely so. Yes, obsolete methods of treating pulpitis, which were used several years ago, could harm a child. But, modern methods of treatment allow to exclude the risk of threat to the fetus
• When a pulpitis occurs in a pregnant woman, one should not start the disease. Infection in the pulp can pass into the blood and be passed on to the child. And this can be very dangerous.
• When treating a sick tooth during pregnancy, the dentist will exclude arsenic and other potent drugs. In order to ensure that the child is not harmed when visiting a dental office, it is necessary to tell the doctor about the period of pregnancy, possible allergies to medicines and answer other questions. After receiving the answers, the specialist will be able to choose the course of treatment for pulpitis that will pass for the child without the consequences of

. IMPORTANT: It is impossible to refuse treatment of pulpitis during pregnancy. Toothache in this disease can affect not only the health of a woman, but also her future child.

Prevention of pulpitis

• Prevention of this problem is not only a daily brushing of teeth using special tools. Negative impact on the appearance of pulpitis can be sour and sweet food, as well as too hot and cold food. Therefore, it is desirable to exclude
• In addition, it is necessary to periodically visit the dental office for preventive examination. Pulpitis is most often the result of neglected tooth decay or mechanical injury to the tooth
• If there is a risk of developing this disease, it is desirable to include in your diet more products containing calcium, fluoride and vitamin C. To ensure the intake of sufficient nutrients in the body, you can use vitamin-mineral complexes andSupplements from the pharmacy

Treatment of pulpitis: tips and reviews

Oleg. I do not advise you to start your teeth. And I know this on my own. First I ignored caries, and then it came to pulpitis. First, a very sharp pain, even on the wall climb. And, secondly, the procedure itself is long and exhausting. First open the cavity, then put the medicine to remove the nerve, then clean the channels. By the way, in one of the cleanings a file was left in my tooth. This is a dental device for cleansing. They could not get him out. I still stay in the tooth. Though it does not bother you, but is it not enough? So appreciate your teeth and jogging for inspection.

Xenia. Of course, you need to immediately contact the dentist with pain. But, I was on vacation on the sea and I was "picked up" by this problem. Decided to endure to home. I called my mother, she advised me to make a temporary garlic seal. Garlic must be crushed and mixed with wax. Then you need to roll the ball and place it in the carious cavity. This "seal" must be periodically changed.

Video: Elena Malysheva about pulpitis