Treatment of pulpitis: stages, methods and means. Symptoms of pulpitis: what is important to know with severe pain in the tooth Development of serious diseases such as pulpitis

There are frequent situations when patients instead of the usual diagnosis of "caries" hear "pulpitis". There is an interest in what is the essence of the disease, the differences from external damage, how to treat. In the article we will try to understand the issues that arise in patients, methods of treatment, and other aspects.

Pulpitis - damage to the soft tissues of the dental pulp

The above ailment appears to be damage to the soft tissues of the dental pulp. These structures are an accumulation of neurovascular formations located in the inner layers and root of the system. In the pulp formations there is a large number of nerve endings responsible for its functioning. The disease is a consequence of the incorrect work of a specialist, an advanced form of carious formation or the ingress of pathogenic bacteria, bodies into a damaged pocket. Pulpitis is also possible, the occurrence of which is due to the ingress of harmful microorganisms into the wound, damage.

Forms of the disease

Tooth pulpitis is a serious disease that requires a competent approach, long-term treatment. It is divided into two types according to the form of the course: progressive (acute), chronic. The latter is a consequence of neglect and neglect of the former. At a specific stage, the course of the disease can be transformed into different forms, but it happens that it may not jump from form to form, starting with a sluggish chronic one. One of the cases of severe exacerbations is periodontitis, which can result in tooth extraction, surgical intervention.

Forms of pulpitis disease are different, but they all require a visit to the dentist

The course of pulpitis depends on the cause of its occurrence and has nuances that depend on this factor. Regardless of the etiology of development (mechanical damage, burn, impact, spall, crack, exposure to chemicals, incorrect work of a specialist), malaise is accompanied by tissue changes:

lack of O2;
excess toxins in the body;
decay;
swelling of pulp structures;
circulatory failures.

There are two classifications of progressive disorder - diffuse and persistent. The affected tooth causes discomfort with and without exposure to objects (food, hot, sweet, closing of the jaws), the pain is permanent, persistent, worse in the evening. There are breaks between waves.

What is diffuse pulpitis?

Examination at the dentist will identify the type of pulpitis and begin treatment

The peculiarity of this form is the spread of damage to the trigeminal nerve, located in the depths of the tooth, the signs are shooting pain in the ear, jumps in body temperature, headaches, aching back. Diffuse pulpitis is difficult to diagnose, so doctors resort to x-rays.
Local tissue destruction is characterized by concentration in a single tooth. The client can easily determine where exactly the damage lay.
Surgery, tooth and nerve extraction can be the consequences of three subtypes of chronic pulpitis: ulcerative, fibrous and hypertrophic. In order:

there is decay of the pulp and upper parts of the tooth, often inflammation of the root canals. The formation of gangrene, ulcerative foci is characteristic;
the part of the tooth that has changed the structure, which is under inflammation, degenerates into fibrous tissue, which is rejected by the body;
the second name is foreign meat. The result of inflammation is swelling, growth of the gum shell (tooth socket), which closes the pulp canal of the tooth and prevents it from functioning.

The sluggish form of malaise is characterized by the absence of discomfort, rare aching attacks. It is actively manifested when interacting with hot, sweet. Deviations from the norm are possible, depending on the individual characteristics of the organism.

Chronic pulpitis may develop after surgery

Maintaining the functioning of the immune system is important. An elementary disease, a cold, can give impetus to the development of pulpitis.

Symptoms

Any pulpitis is characterized by anxiety:

powerful incessant toothache, aggravated at night, temperature change;
the waves are of a lingering character in the initial stages;
in later periods, there are strong constant unpleasant sensations that radiate to other parts of the body;
when force is exerted on the tooth, pain occurs.

For acute pulpitis are inherent:

discomfort of the jaw, which has a diseased object, adjacent organs (ears, cheekbones);
temporary exacerbations;
pain remains without the presence of an object that causes it;
increased sensitivity.

When removing the irritant from the diseased tooth, the pain can stretch for twenty minutes, this is the main difference.
Chronic symptoms are listed below:

absence, full or partial, of pain when exposed to the tooth;
discomfort when tapping;
the fibrous form goes unnoticed;
pulpitis of temporary teeth on radiography is expressed by a change in the structure of soft tissues near the tooth;
gangrenous manifests itself when the temperature of the influencing object changes.

In 50% of cases, chronic pulpitis proceeds as acute, but with periods of remission. The first is much more difficult to treat than the second, as is the diagnosis.

Causes

To date, many factors are known to influence the development of infirmity. The main one is to get into the pulp of infectious diseases that enter the tubules open with carious formation.

There are many factors that influence the formation of pulpitis.

Let's get acquainted with the most important causes of inflammation of the soft tissues of the tooth:

active vital activity of viruses, microorganisms inside the carious formation, products of their life and decay. They multiply quickly, treatment cannot be delayed;
poor treatment of caries. The aforementioned bacteria are formed under the filling tissue, for lack of a way out, starting destructive activity;
mechanical damage, trauma (splint, chip, crack, bruise, impact);
ignoring the presence of caries;
exposure to medicinal substances containing aggressive chemicals;
thermal burn of the pulp caused by powerful drugs;
incorrectly performed surgical operations of various directions;
weakening of local or whole immunity, system malfunctions.

It is important to know that the primary cause of damage to pulp tissues is infection in the deep structures, the nerve. If the pulp remains open as a result of trauma, inflammation may develop after a few days.

Pulpitis accompanied by pain

Out of nowhere, the disease cannot come from, such clients are extremely rare, which is considered almost an anomaly. The disease occurs in healthy teeth, due to the presence of damage.

Disease in children

The teeth of small people are much more at risk of damage, the total area of pulp structures is larger, the enamel layer, the coronal surface is smaller. The metabolism is not normalized, the intake of calcium and minerals is difficult. The root canals are shorter and narrower, there is an abundance of apical foramina, porous mucous tissue. The child is not fully developed endocrine and digestive systems, which can give impetus to the development of inflammation, damage. The course of the disease of the child has a number of features:

the severity of the transfer. It is difficult for an organism that is not fully developed to fight pulpitis, inflammation;
misdiagnosis. Young patients are not able to accurately determine the focus of pain and answer whether the correct tooth is cured. In the early stages of development, the disease cannot be detected, unlike adults;
parents do not notice pulpitis at an early stage, so they do not immediately contact a specialist. The disease flows into a more severe form, worsening the general situation.

Children are more at risk of developing pulpitis

Diagnostics

Diseases of the oral cavity, including pulpitis, in clients have a number of nuances that depend on the person himself, on which category he is a carrier of. Chronic diagnosis is more difficult due to the complete absence of symptoms. Sometimes the pain from one tooth is distributed along the jaw, making it difficult to find its culprit. Identification of the disease should take into account aspects of the causes of the disease, individual requirements, intolerances of the patient.
Diagnosis includes two stages: external examination (the symmetry of the facial oval is checked, the presence of swelling, edema), radiography of different directions. Attention is paid to the patient's feelings (characteristics of pain, frequency of attacks, intervals). The examination allows the dentist-therapist (to treat pulpitis is trusted by such a class of specialists) to classify the disease, prescribe, and carry out the correct removal of damage.

Lesions on different types of teeth

Treatment of pulpitis can only be carried out by a dentist

No matter how depressing it may sound, pulpitis is formed on all teeth, front and back, lower, upper.
Anterior teeth are rarely damaged. The affected tissues are clearly visible through the enamel layer, which is visible to the naked eye, there are frequent waves of pain in opposite sectors. Treatment consists of taking strong drugs, antibiotics. Drawing up an accurate list of medicines is a piece of jewellery, which directly depends on the individual characteristics of the client's body. For the front teeth, the appearance is extremely important, the treatment is carried out very carefully, with minimal removal of tissues, and the maximum possible preservation of a decent appearance.
back tooth. The procedure for the removal of inflammation seems to be especially complicated, in such objects three important elements of the pulp are connected, titanic efforts are required for the correct operation. There is a method of treatment with nerve reservation, it is possible when more than sixty percent of the total tissue is preserved.
Wisdom tooth. This type is equally susceptible to damage, the symptoms are similar to the previous forms, the treatment is the same. The peculiarity is the high risk of removal due to difficult communication with the tooth.

Treatment

The procedure is carried out in one or two visits to the doctor's office. Two outcomes: removal of the dead layer by surgery under local anesthesia or putting arsenic in the pocket, killing the tissue, further removal without anesthesia. As a result of the actions, the channels expand, so they are sealed with a filling substance. In 70% of cases, it is possible to achieve the preservation of the tooth and normal functioning, but there are frequent cases of tooth extraction due to the impossibility of functioning. Conventionally, there are two forms of treatment:

surgical. Complete removal of damaged tissues is performed under local or full anesthesia, depending on the wishes and capabilities of the patient. Eradication is done either before or after cutting the root. It is important to seal the channels with high quality, otherwise the disease will develop again.
preserving structures. This method is not applicable in all cases. Most often to young people, when pulp tissue destruction is recoverable, regenerated (mechanical damage). The essence of the procedure, as with caries, is drilling and surface filling. Antibiotics, antimicrobial agents, anti-inflammatory therapy are widely used. The use of alcohol, essential oils is contraindicated.

Surgical treatment is performed at the dentist

When choosing filling substances, the dentist carefully analyzes the nature of the disease. The wishes of the client are taken into account. The abundance of materials that help to correctly cope with the task is great. Today, metal flexible inserts are often used to replace the structural tissues of the pulp. Radiography after the procedure is carried out in order to convince the correct installation of seals. Remember - the higher the prestige and reliability of the clinic, the higher the quality of the work done by the doctor.

side ailments

If you think that ignoring pulpitis is not fraught with anything, we dare to upset: there are a lot of complications that arise as a result of drowning out symptoms with analgesics, folk remedies.
The first thing you will have to face is periodontitis of the tissues located around the tooth.

Various side effects may occur if pulpitis is ignored.

Most often, patients turn to the acute stage of pulpitis, when the pain turns into throbbing, not allowing to live in peace, causing discomfort even when touched with the tongue. When the tooth is opened, an unpleasantly smelling purulent substance comes out of it. If the fluid is not removed from the cavity in time, the formation of a cyst or granuloma and further removal of the tooth or nerve are likely.
The chronic stage is characterized by periodic remissions. The accumulation of pus in the periodontal canal causes the appearance of a fistula, a process extending from the root of the diseased tooth into other tissues. This channel at short intervals ejects fluid outward, temporarily relieving pain.
These complications of pulpitis are relatively moderate in comparison with those listed below, they affect only the health of the oral cavity, a particular tooth, and in extreme cases threaten with removal, surgical intervention. Next, let's talk about diseases that affect all aspects of health in general.

If pulpitis is ignored, complications may occur.

Periostitis- violation of the structure of the jawbone of the skull, due to the ingress of putrefactive fluid. Symptoms are expressed in lethargy, fever, headaches. There may be a feeling of tooth loss.
Osteomyelitis. An advanced form of periostitis, which consists in the spread of pus over the jaw area, loosening of adjacent teeth.
Abscess, phlegmon. The disease is a severely neglected form of complications of pulpitis, which leads to toxic poisoning, paralysis and death. Purulent fluid spreads into the cavity between the jaw and muscles, preventing them from functioning normally. The activity of blood vessels is disturbed, blood starvation occurs.

Treatment of pulpitis is easy in the early stages

Treatment of advanced pulpitis is extremely difficult. Surgical intervention, removal of the entire tooth or breaking off lead to toxic poisoning, the spread of infection. Breakage, fracture of the jaw or part of it is possible, a serious surgical operation is needed, in the process of development of osteomyelitis, decomposition of bone tissue occurs, rotting, which leads to serious injuries of severe severity.

Prevention

An effective precaution against malaise is the observance of elementary rules of oral hygiene, timely visits by a specialist, careful treatment of caries and prevention of its occurrence.
If the patient stubbornly ignores the first signs of a serious illness, get ready to say goodbye to dental health. To avoid long-term, painful procedures, get rid of germs before they become a health hazard.

Untimely access to the dentist will lead to the transition of inflammation to the bone tissue and the development of periodontitis. Because of this, the treatment will become more complicated, and the most likely outcome will be the extraction of the tooth. This complication can also appear with improper treatment. If the doctor introduces an infection into the canals or the tightness of the seals is insufficient, then complications cannot be avoided. Experts recommend the use of treatment technologies with insulating curtains. Cleaning and processing of channels is much better when using a visiograph, an operating microscope, an endomotor or a binocular.

To consolidate the result and avoid complications, follow 5 rules:

Do not eat solid, sweet and sour foods for 2 days. Reduce chewing load and give preference to soft foods.
Avoid tea, coffee, carrots, beets and other coloring foods for 2-3 days. This will stain the filling.
Visit the specialist exactly at the time specified during the consultation. Often after surgery, you need to visit the doctor after 2-3 months to track progress.
See your doctor after 7 days if the pain and burning sensation persists. Do not use painkillers - contact a specialist immediately.
Prevent the development of caries and other diseases. Visit the dentist 2 times a year to eliminate pathologies at an early stage.

Popova Natalya ViktorovnaDirector, dentist

What is pulpitis, dental pulp? What threatens and why it is necessary to undergo regular examination? Let's look into these issues.

Many initially recognized only already in the dentist's office Small cavities on the surface of the tooth, violation of the integrity of the tooth enamel leads to the fact that pathogenic microbes get inside the tooth. This is where bacteria thrive. They multiply by "eating" the tissues of the tooth and moving deeper and deeper.

During this period, you can not always suspect something was wrong. Often cavities are located in places that you cannot see (on the inside of the tooth or in the interdental spaces). As long as the cavity is small, it rarely causes pain. Often these cavities can only be detected by a dentist during an X-ray examination.

In some cases, some sensations are still there. It can be a reaction to sweet, sour, cold, food stuck between the teeth..

The discovered cavity is easy to cure. Usually, the doctor diagnoses you with caries, removes tissues “spoiled” by microbes, and puts a filling.

Such treatment is possible if you turn to a specialist in time. If you don't have regular check-ups and you don't have any symptoms of caries, bacteria will eventually reach the dental pulp. There is a sharp pain in the tooth. The doctor diagnoses - pulpitis.

What is a pulp (pulpitis) and why does its inflammation cause such pain

The pulp is the internal tissue of the tooth, which contains blood vessels and nerves that supply the tooth with nutrients. Thanks to the pulp, the hard tissues of the tooth (enamel and dentin) are able to receive everything they need, especially calcium, which is so necessary for the integrity and resistance of the tooth to external influences.

With the thinning of the dentin, which separates the external environment and the pulp, the so-called initial pulpitis occurs. There is no damage to the pulp yet, but there is already a toxic effect on it of the waste products of pathogenic bacteria.

At the first stage of treatment of pulpitis, after setting anesthesia and removing “spoiled” tooth tissues, it is not always possible to make a correct diagnosis. Often the doctor cannot be absolutely sure that microbes have not penetrated into the pulp, and the process of destruction of the pulp has not begun.

The most accurate criterion for assessing pulp viability is time. What does it mean? The doctor applies a medical bandage to the bottom of the cavity, which will strengthen and thicken the bottom, as well as prevent the penetration of bacteria and their toxins into the pulp. Then a temporary filling is placed. The tooth is monitored for two to four weeks. If the tooth does not bother you, a permanent filling will be placed at the next visit.

However, even this cannot be an absolute indicator that the pulp is alive and well. There is a so-called asymptomatic course of pulpitis. Therefore, even after setting a permanent filling, it is necessary to observe the tooth for at least a year. At periodic check-ups (once every six months) It is advisable to take an x-ray, and also assess the viability of the pulp using various tests.

"Why all this complexity?" you say. "Maybe just remove the nerve?"

A tooth devoid of pulp becomes brittle over time, its walls are chipped off. The color of the tooth changes, it acquires a grayish tint. Most often, the doctor suggests covering the tooth with a crown to avoid complications. Yes, and the removal of the nerve procedure is not as simple as it seems at first glance. In the root of the tooth, in addition to the main canal, which is visible to the doctor and can be processed, there is a whole system of microtubules that the dentist, armed with even the most advanced microscope, cannot go through purely physically. According to Russian and European studies, only 60% of "dead" teeth do not have complications after treatment.

The procedure for the treatment of pulpitis

So, the doctor, with your full understanding of the situation and consent, tried to save your tooth. But something went wrong. After a temporary filling is placed, the tooth continues (or begins) to hurt. You are diagnosed with acute or chronic pulpitis, it doesn’t matter, the doctor’s tactics are the same - the pulp (nerve) must be removed.

The procedure is performed in one or two visits., depending on the number of channels and their degree of accessibility and curvature. The treatment of such a tooth ends, in which the nerve has been removed by filling or, more often, restoration. The filling or restoration is strengthened with various pins. If necessary, the tooth is covered with a crown. The assessment of the need for a crown is determined by the doctor according to the degree of preservation and fragility of the remaining tooth tissues.

The treatment is considered completed only when all the stages are completed, up to the placement of the crown on permanent cement.

Warranty obligations begin from the moment when the treatment is completed and apply to the filling, restoration and crown.

Warranty obligations for canal treatment cannot be provided due to the above difficulties in their treatment. The doctor can only guarantee that the treatment he performed was carried out in accordance with today's accepted standards and at a high professional level.

So, the treatment is carried out, but do not forget about possible complications. Be sure to undergo preventive examinations every six months. X-ray examination of the treated teeth will help to identify and eliminate the problems that have arisen in time.

Take care of your teeth.

Stay healthy.

Most people go to the dentist for emergency care for the simple reason that they did not pay due attention to caries, considering it to be some kind of “annoying misunderstanding” that may well wait until there is free time for its treatment. As a result, most often acute pain is no longer caused by caries, but by pulpitis, which is associated with damage to the soft tissue inside the tooth. And often the symptoms of pulpitis continue to be confused with caries, hoping once again to wait out or drown out the pain with painkillers.

But the defeat of the pulp chamber of the tooth is still far from the limit. The result of excessive "forbearance" is often the transition of pulpitis to more difficult to treat diseases - periodontitis. Often, the outcome of complications of pulpitis is the removal of a tooth, after which there may be a displacement of adjacent teeth, malocclusion, normal chewing of food, and sometimes diseases of the stomach and intestines.

The photo below shows a tooth in which deep caries led to the development of pulpitis:

Many people know firsthand about the possible appearance of the so-called "flux" (periostitis). But few people know that the gum flux often appears after prolonged pulpitis pain and is the result of the death of the “nerve” in the dental canal with the formation of pus, which simply has nowhere to go, and therefore it goes towards the root of the tooth, swelling the gums.

Over time, the flux can turn into a fistula (see photo):

What is pulpitis, what are the causes of its occurrence, how it can threaten human health and what varieties of this pathology are - all this will be discussed further.

It is interesting

The pain that can occur when exposed to the "nerve" of the tooth was known long before the advent of modern dentistry. During the Inquisition, the first primitive hand tools (something like drills) were used for torture, which, when rotated, crushed enamel and dentin and reached the soft tissues inside the tooth, thereby causing their irritation and destruction.

Of course, everything was done in order to cause unbearable pain in the subject, and it came to loss of consciousness and pain shock. Then the sufferer was brought to his senses in order to continue the impact on the pulp. Sometimes the torture lasted more than one day, and the person died from traumatic shock.

So what is pulpitis?

Pulpitis is an inflammatory reaction of the pulp tissue (dental “nerve”) that occurs in response to an irritating factor, external or internal. The pulp is a soft tissue filled with blood vessels and nerves. There are a great many nerve cells inside it, which is why toothache is considered one of the strongest.

Photos of the dental pulp:

Why does pulpitis cause such severe pain?

Due to the fact that the inflammatory reaction has an edema phase, during the increase in pulp size, compression of nerve cells occurs with the development of severe unbearable pain. When the pulp is closed with a thin layer of carious tissues, and in chronic forms, when the pain is not so pronounced, most often the bottom of the carious cavity communicates with the pulp chamber. In such cases, the pain is aching in nature and becomes pronounced only when irritants enter the “hollow” of the tooth (hot, sharp), or due to complete blockage of the hole above the pulp with something (seeds, nuts, apples).

As a result of edema and compression of the entire connective tissue bundle, gradual necrosis (necrosis) of the "nerve" occurs.

If you thought that this "horror" ends, then you will have to disappoint. The above complications of pulpitis were "peaceful" themselves, which most often lead only to tooth loss, but there are diseases that affect the general health of a person: periostitis, osteomyelitis, abscess, phlegmon, sepsis.

Periostitis is an inflammation of the periosteum of the jaw against the background of the spread of pus under it. As a result, the state of health worsens, the temperature rises to high values, the shape of the face may change, there is a feeling of fullness in the gums near the diseased tooth. Often, after these serious conditions, a person more than once regrets that he did not treat a relatively harmless pulpitis in time.

Osteomyelitis is a melting or dissolution of the bone, when the purulent process covers the spaces of the jaw so much that, in addition to the diseased tooth, the adjacent teeth also begin to stagger.

On a note

With a long-term development of osteomyelitis, a person may seek help from a dental surgeon to eliminate the source of infection, but the result of the removal of a diseased tooth may be a part of the jaw broken off along with it or a fracture. Since in the process of progression of osteomyelitis the bone becomes less strong due to its "dissolution", even a small effort often leads to its injuries of varying severity.

Abscess (limited purulent inflammation) and phlegmon (diffuse purulent inflammation) are diseases that develop against the background of complications of pulpitis and often lead to the death of a person. They are associated with the active germination of the focus of infection in the spaces between the muscles, where vital formations (vessels, nerves) are located.

In the photo below - phlegmon:

Sepsis is the infection of the blood with toxic products of infection, leading to intoxication of the body, a violation of its defenses and, ultimately, sometimes death.

How to recognize pulpitis yourself

In order to prevent serious complications in time, it is useful to be able to independently recognize pulpitis at the very first time. It's not that hard to diagnose yourself.

When toothaches occur, one should, first of all, understand their nature: with caries, there is no acute spontaneous pain, it appears only from external stimuli. In acute pulpitis and its exacerbation, both of these signs are present. And in acute periodontitis, the tooth most often cannot be touched at all, the state of health may worsen, hotter sharply increases the already unbearable throbbing pain.

Chronic pulpitis is more difficult to detect, but with the possibility of examining the carious cavity, it becomes easier to recognize pulpitis. If some soft tissue occupies the carious cavity, then, most likely, chronic hypertrophic pulpitis develops. If prolonged aching pain occurs when food enters the tooth, then there is a high probability of an open nerve, as with fibrous or.

Chronic periodontitis has much in common with chronic pulpitis, but only in chronic forms of periodontitis can there be fistulas on the gums near the diseased tooth. Only with periodontitis, the gum near the tooth can “swell”, hurt, and pus is often released from under it.

Despite the possibilities of self-diagnosis, only a dentist can make a final diagnosis by conducting a set of diagnostic measures (examination, palpation, percussion, thermometry, EDI, radiography).

The photo below shows a visiograph for X-rays:

Treatment and prevention of pulpitis

After determining pulpitis, the doctor draws up a plan for its treatment. There are 3 approaches to the treatment of pulpitis: with the preservation of the entire “nerve”, with its partial removal, with complete extraction of the pulp from the horse canal system.

The first method of preserving the entire pulp in a viable state is currently not popular due to frequent complications, so doctors usually prefer the latter option. Partial pulp removal is also used, but only when it is not possible to go through the entire canal due to its complex structure or the presence of foreign bodies in it.

The main importance in the full treatment of pulpitis is a good drug treatment of the canals and their sealing to the physiological apex (apex). For this, anesthesia is necessarily done, the canals are processed with special tools similar to needles (files), washed with antiseptic solutions and sealed with hardening pastes with or without gutta-percha pins.

On a note

Often, the treatment of pulpitis takes from 1-2 to 3-4 visits. This is due to the approach to treatment, with or without the use of pastes for necrotizing the “nerve” (arsenic or arsenic-free), with the formulation of special antiseptics or medicines for additional disinfection of the canals, designed for several days.

Fine . With restrictions, the presence of post-filling pains after treatment for no more than 5-7 days is allowed, which are manifested only by discomfort when biting on a tooth (especially solid food).

In order to prevent the development of pulpitis, timely treatment of caries that has arisen on the tooth is important. This is the minimum program. As for the maximum program, prevention should begin even before the onset of caries, and follow the recommendations aimed at strengthening the teeth and protecting them:

To carry out cleaning with toothbrushes and pastes of all accessible surfaces of the teeth every time after eating;
Clean the gaps between the teeth with flosses (threads);
Do not abuse sweets;
Carry out professional hygiene once every six months (cleansing from plaque and stone);
Carry out remineralizing therapy and deep fluoridation of all teeth in consultation with the dentist.

And this is what the treatment of pulpitis looks like

Root canal treatment

What is pulp

The pulp consists of connective tissue, which is rich in blood vessels and nerves, its coronal part is a rather loose structure and follows the contours of the tooth with peculiar processes in the region of its tubercles.

The structure of the root part is more dense. The pulp acts as a powerful protective barrier against all kinds of bacterial infections, but this function weakens under various negative influences.

Causes of pulpitis

Approximately 20% of patients in dental clinics are diagnosed with inflammation of the pulp - pulpitis. This disease occurs mainly as a result of bacterial infection, usually coccal microorganisms (staphylococci, streptococci, etc.). Infection comes from the carious cavity.

Pulpitis can occur with various mechanical influences, as a result of toxic poisoning due to poor quality filling material, when a dental crown is broken off, as well as in the treatment of deep caries ( with the destruction of the carious bottom).

Inflammation can be caused by periodontitis. In this case, the infection of the tooth root occurs with pathogenic microflora contained in periodontal pockets.

As a result of unprofessional actions of a dentist when treating a carious cavity (insufficient water cooling, too high drilling speed), a thermal burn of the pulp may occur; excessive drying of the contact surface with the filling material can lead to an aseptic (non-bacterial) form of the disease.

With incomplete removal of the affected tissues, caries destroys the tooth under the filling, which over time also leads to the described disease.

Forms and symptoms of pulpitis

There are two main forms of the disease, which have similar symptoms (signs) with varying degrees of severity.

Acute pulpitis

The patient suddenly has acute pain attacks. Basically they do not depend on external irritating factors and most often occur at night.

Individuals may have seizures provoked by temperature fluctuations(usually from cold, but sometimes from hot food). Moreover, acute pain disappears approximately 15 minutes after the cessation of the irritating effect.

Often the pain that occurs is not localized in the region of the diseased tooth, but spreads to the entire jaw, which makes it difficult to diagnose.

If left untreated, the serous form can turn into a purulent stage. The pains intensify and acquire a "shooting" character, the intervals of rest decrease (sometimes to zero).

The severity of the disease depends on the type of microorganism that caused inflammation, as well as on the strength of the immune response, which decreases with age.

Chronic pulpitis

As a rule, it develops after the completion of the acute stage, but it can also occur on its own. Depending on the severity, the following forms are distinguished:

fibrous(simple). Pain appears only under the influence of mechanical or chemical stimuli, as well as with sudden temperature changes;
polyferative(hypertrophic). The cavity of the tooth is open and bleeding, when food gets there, pain occurs;
gangrenous chronic.

A person feels fullness in the tooth, sometimes there is pain when eating hot food. On the right is a photo that clearly shows what chronic tooth pulpitis is.

Under the influence of adverse factors, an exacerbation of the disease can occur. In this case, the pain intensifies and is often spontaneous.

Treatment

A neglected disease leads not only to a complete defeat of the pulp, but also to the occurrence of inflammation in the surrounding tissues (periosteum, periodontal tissues and gums). Therefore, it is important to seek medical help as soon as possible.

Conservative treatment

A conservative (biological) method is indicated for young people (under 30 years old) who do not have other diseases, if no more than two days have passed since the onset of pain. With this treatment, the pulp retains its viability.

Dentist:

performs anesthesia;
opens the cavity of the tooth;
removes inflamed tissue;
lays a special healing ointment;
puts a permanent or temporary filling.

In the second case, the final filling is carried out in a few days (subject to positive dynamics).

Surgical treatment

There are two methods of surgical treatment. In the first, amputation, the coronal part of the pulp is removed. Indications for use: chronic fibrous or acute serous pulpitis. With the extirpation method, the entire pulp of the tooth is removed. Indications: all types of diseases, especially advanced forms (purulent, gangrenous).

Amputation method

The dentist performs the following actions:

conducts anesthesia;
opens the cavity of the tooth;
removes the coronal part of the pulp;
flushes the treated cavity with special solutions;
lays a healing ointment;
puts a filling.

Extirpation method

When implementing this method of treatment, two options are possible: the use of anesthesia ( vital extirpation) and necrotization of the dental pulp with special means ( devital extirpation). Basically, vital extirpation is used, since the treatment is carried out in one session.

In both cases, the dentist:

completely removes the pulp;
treats root canals and rinses them with special solutions;
carries out sealing of channels;
final filling of the tooth.

wisdom tooth pulpitis

Wisdom teeth are more susceptible to this disease. The factors causing inflammation, symptoms and treatments do not differ from those described above. In most cases, wisdom teeth are located incorrectly, and access to them is extremely difficult. Therefore, dentists usually suggest these teeth are not treated, but removed.

Pulpitis of milk teeth. Its symptoms and treatment

Pulpitis in children is diagnosed more often than in adults. This is due to the fact that the pulp and surrounding tissues have not fully formed. In addition, children's immunity is imperfect and cannot fully fulfill its function of protecting the body from infections.

Inflammation that is not cured in time is fraught with very serious problems: the tissues of the oral cavity surrounding the tooth are involved in the pathological process.

In most cases, pulpitis in children is asymptomatic. Parents need to pay more attention to this problem, visit the pediatric dentist regularly(Prophylactic examinations should be carried out every six months).

Just like in adults, the main cause of the disease is caries that has not been cured in a timely manner. Inflammation can occur from mechanical injuries, improper treatment (thermal overheating during the treatment of a carious cavity), toxic effects (installation of poor-quality fillings), and a cold infection.

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Here: - an effective recipe for the treatment of flux at home with aloe is offered.

Here is a general description of the main forms of pulpitis of milk teeth:

hypertrophic

In this form (which is very rare), the tooth is completely destroyed, the pulp grows and bleeds when probing. When eating, the child may feel slight pain.

Gangrenous

The pain is almost not felt (even when opening the cavity). The tooth darkens. Lymph nodes usually increase in size.

Chronic

This form is characterized by constant aching pains, which are aggravated by the presence of irritating factors. There may be swelling of soft tissues, lymph nodes increase. With exacerbations, the symptoms intensify. The child feels a general malaise, body temperature may rise.

Treatment is carried out by the same methods as in adults: with a conservative (biological) method, the viability of the pulp is preserved, with a surgical one, either complete or partial depulpation is performed (extirpation or amputation method).

What are the features of pulpitis of milk teeth - we learn from the following video:

Treatment with folk remedies

The ideal case is to visit a dentist on the first day after the onset of symptoms of the disease. For temporary pain relief (up to three days), alternative methods can be used.

It makes no sense in this article to duplicate a huge number of recipes for healing potions: if you wish, you can easily find them on the Internet. The main thing is to remember: this disease can not be cured by folk remedies.

To relieve toothache, various products of plant or animal origin are used: sage, calendula, willow bark, ginger, bay leaf, mint, eucalyptus, pine resin, beets, garlic, lard, propolis ... Well, the most favorite method among the people is - mouthwash with baking soda.

Price of tooth pulpitis treatment

It is impossible to give an unambiguous answer to the question - how much does it cost to cure tooth pulpitis. The price of medical services depends on many factors: the pricing policy of the clinic, the cost of filling materials, the structure of the tooth.

For example, the treatment of pulpitis of a three-channel tooth (without including the price of the filling itself) can result in an amount of 3 to 4 thousand rubles, a "simple" tooth - about 500 rubles. Installing a seal can cost from 500 to 1-2 thousand rubles.

Any citizen of the Russian Federation with a medical insurance policy has the right to apply to a state dental clinic for free medical care.

Conclusion. Once again about the need for timely treatment

A neglected disease can lead not only to tooth loss. Inflammatory processes can affect the surrounding tissues of the oral cavity with very unpleasant consequences for a person. A properly treated tooth can last for many decades without causing discomfort.

It is necessary to mention the financial side of the matter. In case of loss of a tooth, it is necessary to install its prosthesis, the cost of which can be tens of thousands of rubles. So the choice is yours.

As a summary, let's watch the video and find out, this time visually, how the pulpitis of the tooth is treated:

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