Pulpitis is an inflammation of the tooth pulp (nerve), which can give you a throbbing tooth. It can be VERY painful!
It's a slightly strange-sounding word - where does it come from?
We've all heard of other "inflammation" words like dermatitis and meningitis. They all have ". . .itis" at the end. So the ". .itis" at the end of "pulpitis" tells us that it is an inflammation of the pulp.
Pulp seems to be an odd word for the nerve inside a tooth. But the word "pulp" really just means something soft and mushy.
It's a more accurate word than "nerve" for what's inside a tooth, because there are tiny blood vessels in there too. Not just tiny nerves.
There are basically two types of pulp inflammation that you need to know about. One type can get better. It's called "reversible pulpitis". The other type cannot get better. Naturally enough, it's called "irreversible pulpitis".
There are some other names used, such as acute and chronic, but for most patients, we just need to know if it's going to get better or not.
What are the causes of pulpitis?
A leaking filling or crown (cap). (Reversible)
A cavity in a tooth. (Reversible)
Trauma: A knock or a blow to the tooth. (May be reversible)
Tooth grinding over many years. (Unlikely to be reversible)
Overheating from dental procedures such as preparation for a crown. (Unlikely to be reversible)
A filling or a cap that is too big, causing repeated biting from the opposite tooth. (Reversible)
Bacteria - Bacteria from decay getting inside the nerve. (Not reversible)
Tooth sensitivity and pain.
The tooth may react to hot, cold, sweet things and acidic foods and drinks, and may be tender to bite on.
What's important is HOW the tooth reacts to these things.
The REVERSIBLE forms of pulp inflammation have the mildest symptoms. The tooth may be sensitive to cold, for example, but only for 5 or 10 seconds or less. The tooth only hurts when you get something on it - if you leave it alone, it's fine. And you know pretty much exactly which tooth it is. You can pick the tooth without much doubt.
The IRREVERSIBLE forms have a few key differences:
So you put the coffee down, and do something else for a minute. But the pain continues to get worse, even 4 or 5 minutes AFTER you had the hot drink. This is the "throbbing tooth" stage.
Once the pulp has reached this stage, a cold drink can actually make it feel better. Occasionally, I'll see a patient booked in for toothache walk into the room holding a water bottle. As we have a talk about his problems, he takes a swig of water every 30 seconds or so.
This is telling me that the tooth is painful to the warmth of his cheek, and the cold water is taking the edge off the pain. I know within a minute that he has an irreversible pulpitis.
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What are the treatments for pulpitis?
The REVERSIBLE forms are easily treated by removing any decay and replacing any leaking fillings, and adjusting any fillings that are "too big".
There are only 2 treatments for IRREVERSIBLE conditions. No easy solutions, I'm afraid:
For more information about these two options for treatment, have a look at;