Pulpitis: A Painful Dental Emergency Not to Be Ignored

Pulpitis, also known as a "severe toothache," is an inflammation of the dental pulp that manifests as intense, throbbing pain. This dental emergency affects many people and requires prompt attention to relieve symptoms and avoid complications. Discover the causes, signs, and what to do when faced with this common problem.

What Exactly is Pulpitis?

Pulpitis is an inflammation of the soft tissue located in the heart of the tooth, called the dental pulp. This pulp contains the nerves and blood vessels responsible for the tooth's vitality. When the pulp is irritated, it reacts by triggering a painful inflammatory response.

The main causes of pulpitis are:

• Dental Cavity: Bacteria from a cavity reach the pulp and cause an infection.
• Dental Trauma: A blow to the tooth can injure the pulp and disrupt its blood supply.
• A Cracked or Fractured Tooth: The pulp is exposed to external aggressors.
• Aggressive Dental Treatment: Deep cavity preparation, overheating during drilling, or overly concentrated whitening.
• Severe Periodontal Disease: Inflammation of the bone and ligament can spread to the pulp.

Certain conditions (immunosuppression, diabetes) also promote the onset of pulpitis. A tooth that has had a root canal cannot develop pulpitis.

What Are the Different Types of Pulpitis?

There are two main forms of pulpitis, depending on the stage and reversibility of the inflammation:

• Reversible Pulpitis: The inflammation is moderate, and the pain subsides when the stimulus (sugar, cold) is removed. A conservative treatment (filling) is still possible to preserve the pulp's vitality.
• Irreversible Pulpitis: The inflammation is widespread, and the pain is intense, continuous, and pulsating. Pulp death (necrosis) is inevitable. An endodontic treatment (root canal) or extraction is necessary.

Without treatment, irreversible pulpitis progresses to pulp necrosis and then to apical periodontitis (infection of the bone around the root). A cyst or dental abscess can complicate the situation.

How to Recognize Pulpitis

Pulpitis most often manifests as a sudden, intense toothache. The characteristic signs are:

• Spontaneous, throbbing, pulsating pain that radiates to the jaw.
• Pain that worsens at night, when lying down, and with exertion.
• Pain triggered by hot, cold, or sugar, which then lingers.
• Pain on chewing and pressure on the tooth.
• A sensation that the tooth is "higher" than the others.
• Swelling of the gum and cheek near the tooth.

The pain can be so severe that it wakes you up at night and does not respond to standard painkillers. It may be accompanied by a headache, fever, and fatigue. In such cases, you should seek emergency dental care.

What to Do in Case of Dental Pulpitis

Managing pulpitis has two objectives: relieving the pain and treating the tooth. The methods used differ depending on the type of pulpitis:

• Reversible Pulpitis: A sealed filling after removing the decay and protecting the pulp.
• Irreversible Pulpitis: Endodontic treatment (root canal) to remove the infected pulp and fill the canals, or tooth extraction if the tooth is too damaged.

Medication is often associated with the treatment:

• Pain Relievers like ibuprofen or acetaminophen. Stronger medication like tramadol may be prescribed for severe pain.
• Anti-inflammatories to reduce swelling.
• Antibiotics in case of fever or abscess.

In any case, a dental consultation should not be delayed by more than 24 to 48 hours. Without care, the risk of infectious complications is significant.

How to Prevent Pulpitis

Prevention of pulpitis involves good daily oral hygiene and regular dental check-ups:

• Bi-daily brushing with a fluoride toothpaste for 2 minutes.
• Use of dental floss and interdental brushes to remove plaque.
• Annual consultation with radiographic control and professional cleaning.
• Prompt treatment of cavities, cracks, and other dental pathologies.
• Wearing a mouthguard for contact sports or if you have bruxism.

Conclusion

Dental pulpitis is a common and painful dental emergency that requires a quick visit to the dentist. Painkillers, anti-inflammatories, and sometimes antibiotics will help relieve the symptoms while awaiting treatment.

Most often, a filling or root canal is sufficient to preserve the tooth long-term. But in some advanced cases, extraction is the only possible option. The sooner the treatment, the better the chances of saving the tooth.

Frequently Asked Questions About Dental Pulpitis

What are the first symptoms of pulpitis?

A sharp, throbbing, pulsating pain, worsened by hot and cold, radiating to the jaw, and waking you up at night should make you suspect pulpitis. The tooth may also be very sensitive to touch and chewing.

How quickly does pulpitis develop?

Pulpitis can develop over a few hours or a few days, depending on the cause. Without treatment, it evolves to pulp necrosis in one to two weeks and can then lead to a dental abscess, sometimes several months later.

What can I do for emergency relief from pulpitis?

Take an over-the-counter pain reliever like ibuprofen, apply cold compresses to your cheek, chew on the opposite side, and see a dentist as soon as possible.

What is the difference between pulpitis and an abscess?

Pulpitis is an inflammation of the still-living pulp, whereas a dental abscess results from the infection of the canal after pulp necrosis. An abscess is often preceded by untreated pulpitis but can also occur on a previously root canal-treated tooth.