Pulpitis or inflammation of the dental pulp is the commonest cause of dental pain.Most pulpitis are primarily as a result of dental caries
DISEASES OF THE DENTAL PULP
What is pulpitis?
Pulpitis or inflammation of dental pulp is the most commonest cause of dental pain.
Causes of Pulp disease
Most pulpitis are primarily as a result of dental caries secondary to bacteria invasion of dentine and pulp tissues.
However, pulpal changes may occur in early caries limited to enamel alone as white spots.
Bacteria invasion in the absence of caries occur in tooth fracture or as a result of bacteriamea.
This is termed anachoretic pulpitis which account for insignificant numbers of pulpitis.
Microbes are significant in Aetiology of pulpitis in that surgical pulps exposure in germ free animals did not result in devitalized pulp or Periapical infection even in gross food impaction, in contrast to conventional animal's that rapidly develops acute pulp necrosis.
Pulpitis may arise due to
1. Chemical irritation of the pulp - in pulpal exposures to which irritant medicament is applied.
2. Intact pulp beneath deep or moderate cavity with irritant filling materials. There may be penetration to pulp via dentinal tubules. The pulp may however respond by forming reparation dentine.
3. Severe thermal changes may produce pulpitis which is most common on tooth with large metallic restoration especially with inadequate insulation between the material and pulp.
Heat and more particularlycold, are transmitted to pulp, producing pain and on prolongation actual pulpitis.
Summarily, pulpitis can result from the following:
1. Dental caries
2. Traumatic exposure of the pulp during cavity preparation.
3. Fracture of tooth crown.
4. Thermal injury arising from operative procedures.
5. Chemical irritation due to irritating restorative material.
6. Crack - Tooth syndrome - splitting of a tooth under masticatory process (usually premolar.)
Read: Common Diseases of Child Dental Patient - Dental caries
Traumatic dental injuries and how does it result to pulpitis
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1. Chemical irritation of the pulp - in pulpal exposures to which irritant medicament is applied.
2. Intact pulp beneath deep or moderate cavity with irritant filling materials. There may be penetration to pulp via dentinal tubules. The pulp may however respond by forming reparation dentine.
3. Severe thermal changes may produce pulpitis which is most common on tooth with large metallic restoration especially with inadequate insulation between the material and pulp.
Heat and more particularlycold, are transmitted to pulp, producing pain and on prolongation actual pulpitis.
Summarily, pulpitis can result from the following:
1. Dental caries
2. Traumatic exposure of the pulp during cavity preparation.
3. Fracture of tooth crown.
4. Thermal injury arising from operative procedures.
5. Chemical irritation due to irritating restorative material.
6. Crack - Tooth syndrome - splitting of a tooth under masticatory process (usually premolar.)
Read: Common Diseases of Child Dental Patient - Dental caries
Traumatic dental injuries and how does it result to pulpitis
Classification of pulpitis
Can be classified into acute and chronic
May also be classified into partial , subtotal, or Total
Partial pulpitis occur in confinement to a portion of the pulp. If most pulp tissue is diseased. Generalized pulpitis results.
Presence or absence of direct communication between the pulp and oral environment may give rise to open or close pulpitis
The clinical differences result from presence or absence of drainage of inflammatory fluid.
Focal reversible pulpitis ( FRP)
This is the earliest form of pulpitis which is mild and transients. It is pulpitis which is located to the pulpal end of irritated dentinal tubules.
Clinical features of Pulpitis
Sensitivity to thermal changes especially cold, which disappears on removal of irritant.
There is response to electric pulp tester at low level of current indicating lower pain threshold than adjacent normal teeth.
It is seen in deep carious lesion, large metallic restoration especially without isolation or restoration with defective margin.
Treatment of Pulpitis
1. It is reversible condition; if irritant is removed before severe damage.
2. Carious lesion should be exercised and restored. Also defective filling should be replaced.
What are the Symptoms of pulpitis?
- pain on eating or drinking hot or cold food/drinks.
- dull ache at the jaw.
- pain which is spontaneous and throbbing.
- tenderness at the tooth on touching and biting.
- pain which may interrupt sleep.
- pain which may be referred to head, temple or ear.
Prevention of pulpitis
The best way to prevent toothache is to prevent dental disease. Decay can be prevented by,
- A sensible diet - limit snacking in between meals, and the consumption of refined carbohydrates eg sweets, cake, ice cream.
- Brushing your teeth with a fluoride tooth paste twice daily
- Flossing at least once a day
- Regular visits to the dentist for check up.
Reference
Pulpitis ( reversible/irreversible) - jcda
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