What is pulpitis of the tooth and how to treat this disease?

Pulpitis in the tooth - photo of the oral cavityIn our country, people go to the dentist only when emergency care is needed because of acute pain. And this could have been avoided if we had paid attention to caries in time. Considering it a “misunderstanding” and ignoring is a big mistake.

In fairness, we say that caries cannot provoke a sharp pain. It appears during the development of pulpitis. And again, our people confuse caries with pulpitis, and continue to try to drown out pain with painkillers, which in itself is not effective.

Continuing to endure, a person with pulpitis risks waiting for the development of an even more complex disease - periodontitis.

What is pulpitis?

Pulpitis is called inflammatory processaffecting pulp tissue. In the people, pulp is known as a dental “nerve”. In fact, the pulp is a soft tooth tissue, riddled with nerves and blood vessels. Actually, because of the huge amount of nerve endings, toothache is so strong.

The pain in the pulpitis is due to swelling, which withdisproves the inflammatory response of the pulp. It increases in size, which leads to compression of the nerve endings. The stronger the swelling, the more intense the pain. In acute pulpitis, pain is more pronounced, since the pulp is covered with a layer of caries-affected tissues. In chronic pulpitis, the pain is less pronounced, as the pulp can bulge into the carious cavity. However, in chronic pulpitis, pain may become pronounced when consumed with hot or spicy foods.

Causes of pulpitis

it the disease is always the result of untreated caries. As the carious cavity becomes deeper, germs gradually begin to penetrate into the pulp, causing it to become inflamed.

Dentists identify 2 ways of infection of the dental "nerve":

  • Pulpitis treatment can only be carried out by a dentist.Through the carious cavity in the crown of the tooth.
  • Through the hole in the top of the root. In this case, talking about retrograde pulpitis.

It is worth noting that retrograde pulpitis It is very rare because it has a specific and very complex developmental mechanism. This form of the disease develops for the following reasons:

  • The pulp of the tooth is infected through the blood from the flu, rubella and other diseases.
  • Infection affects the dental "nerve" if its foci are located near the root of the tooth. An example of such an infection is inflammation of the maxillary sinus.
  • Infection through the periodontal pocket, reaching the root of the tooth.

Also causes of pulpitis include dental errors during tooth treatment: overheating during turning, opening the chamber with pulp unnecessarily, incorrect turning of the tooth. It is noteworthy that the pulpitis, developing due to medical error, declare themselves almost immediately.

The rarest pulpitis is considered the rarest. She is develops after a tooth injury: hit or bruised. Most often, this type of disease affects the front teeth. Although this pulpitis is not infectious in nature, its symptoms are no different from the classic symptoms.

Course of the disease

Pulpitis can occur in 3 main forms:

  1. Ostro.
  2. Chronic.
  3. Stage of aggravation.

Pulpitis tooth and its treatmentDoctors most often experience an acute form of the disease. In second place in terms of detection is chronic disease. Pulpitis in the acute stage is less common, since it is a chronic complication.

In some cases pulpit bypass acute form and immediately goes into a sluggish chronic. Moreover, the chronic form can not worsen and immediately go into periodontitis.

The development of the disease is closely related to the cause. But regardless of the cause, the tissue of the dental nerve undergoes the following transformations:

  • Pulp swells.
  • It breaks down blood flow.
  • There comes the oxygen starvation of tissues.
  • Toxins stop being removed.
  • Necrosis develops.

Acute pulpitis

This form of the disease can be focal and diffuse. The main difference between diffuse pulpitis and focal is in the defeat of the trigeminal nerve. In acute diffuse form of the disease, pain may radiate to the temple, ear and under the eye. At the same time, the patient cannot understand what kind of tooth pain occurs. The dentist has to resort to additional diagnostic tools to identify the culprit.

Focal acute pulpitis is characterized by a clear localization of pain. The patient points to the culprit.

Chronic pulpitis

This form of the disease can be fibrous, gangrenous and hypertrophic.

  • The fibrous form is characterized by the degeneration of the affected tissue.
  • The gangrenous form is manifested by the destruction of the pulp itself and part of the tooth root.
  • Hypertrophic pulpitis is expressed by the proliferation of soft tissues, which occupy the entire carious cavity.

Chronic pulpitis to a certain point only show weak pain, but as soon as the patient is overcooled, his immunity is weakened or he becomes ill with the flu, the chronic form of the disease enters the acute stage with severe pain.

Why treat pulpitis?

Sick tooth - photo pulpitisToday the abundance and availability of strong painkillers, allow people to simply cope with toothaches. As a result, people to the last postpone the visit to the dentist. This is fundamentally wrong, because if the pain subsided, it does not mean that the disease has receded. The bacteria are still in the pulp chamber and continue to destroy it, causing irreversible changes in the tooth. Sooner or later, the “nerve” will die and the pus that forms will flow into the root canals.

When pus reaches the tissueslying next to the root of the tooth, there will be a flux. In severe form, this complication can cause severe deformity of the face and lead to conditions that are dangerous for the patient's life. And this is only part of the problem.

The most dangerous complications of the disease

In the development of the complications of this disease always the patient is guilty. He suffers pain to the last and takes various pills to eliminate it. The first and most common complication of pulpitis is acute and chronic periodontitis.

Acute periodontitis forces patients to go to dentists due to severe pain and the inability to eat normally, since it is impossible to touch even a tongue to a bad tooth. Often, this complication is marked with hyperthermia and “growth” of the tooth. It seems to the patient that the aching tooth is given in height above the neighboring ones. When the dentist opens the canal with the pulp, pus begins to flow out.

The chronic form of periodontitis is unpleasant fistulas that appear on the gums. They lead to the channels of the affected tooth. Of these, from time to time the foul-smelling pus expires.

Periodontitis is not the most dangerous complication of pulpitis. There are diseases that can affect the overall health of the patient:

  • Periostitis - infection of the periosteum. The disease develops after pus from the pulp reaches the jaw bone. With periostitis, there is hyperthermia, a change in the shape of the patient’s face, and a general deterioration of well-being.
  • Osteomyelitis. This disease is the melting of bone tissue under the influence of a purulent process. The disease quickly covers the entire space of the jaw.
  • Abscess and phlegmon are complications of pulpitis, which can lead to the death of the patient. This is due to the rapid spread of the source of infection and the achievement of vital organs.

How to treat pulpitis of the tooth?

Pulpitis three-channel tooth - features of treatmentDentist selects a treatment methodbased on their clinical manifestations of the disease. Today, doctors whenever possible seek to preserve at least part of the dental “nerve”. This is necessary in order for the tooth to continue to function normally. However, most often dentists have to perform extirpation.

The meaning of extirpation is to completely rid the tooth of an infected nerve. This step allows you to block the further spread of the infection.

Earlier for treatment of pulpitis often used resorcin-formalin method. Today, it was abandoned, since after it there are often relapses. In addition, after such treatment, the tooth enamel becomes pink or red.

All practiced methods of treatment of pulpitis in modern dentistry are divided into two groups:

  1. Treatment without removal of the dental "nerve".
  2. Complete removal of pulp.

Nerve removal may be partial (amputation) and complete (extirpation).

Biological treatment is used only if the inflammation in the "nerve" is in the very initial stage. Such treatment is very difficult and expensive, therefore resort to it only in very rich clinics. Most dentists do not resort to this method, since the risk of recurrence persists.

Tooth decay and pulpitis - what's the differenceSurgical the treatment is vital and devital. It differs only by the use of a special paste. If it is not used, and the dental “nerve” is removed under anesthesia, then it is a question of vital amputation or extirpation. When the paste is used for the preliminary destruction of the nerve, then it is a question of a devital operation.

Dentists themselves consider the vital amputation the most difficult treatment method. The fact is that it can be used only under the following conditions:

  • The patient has a healthy periodontal disease.
  • The patient is not older than 45 years.
  • Sterility in the office should be perfect.

To successfully complete the procedure have to use powerful anti-inflammatory drugs, which in itself is a risk. Taking into account all the requirements and risks, not all dentists are ready to resort to vital treatment, preferring devital treatment.

Acute pulpitis causes severe painIn Russia, the doctor prefer to remove the entire "nerve", reasonably believing that the remaining tissue creates conditions for relapse. Practice has shown that even the most powerful antiseptic solutions and pastes are not able to protect the root of the tooth from sluggish inflammation.

The removal of the dental "nerve" today, in any case, is carried out under local anesthesia. Used for anesthesia articaine based preparations: Ubestezin, Septonest, Ultracain, etc. After the frost begins to act, the dentist first removes the main part of the pulp and then removes its residues from the canals. If necessary, the doctor expands the channels and treats them with antiseptic solutions. It ends with the installation of a seal.

The quality of treatment of pulpitis often depends not on the quality of the filling, but on the thorough preparation of the canals. A good dentist thoroughly cleans and flushes the canals.

Disease prevention

The best prevention of pulpitis is quality dental care. It consists in the proper selection of brushes and toothpastes, regular dental examinations. One visit to the dental office at 6 months is enough for the doctor to identify the caries that has appeared in time and conduct effective treatment.

Implantation

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