Acute focal pulpitis: symptoms and treatment

Almost all patients learned a toothache, you know the concept of pulpitis. But hardly anyone has delved into an accurate dental diagnosis and learned in the form of pulpitis in the tooth. According to the international classification acute pulpitis has several forms. For each form varies in the symptomatic picture, involves the use of individual methods of treatment. To clarify the type of acute pulpitis uses differential diagnostics, allowing to separate one disease from another and to provide adequate therapy in each clinical case.

What it is

Acute focal pulpitis is a certain stage during the inflammatory process of the pulp. Focal means exactly localized, limited, which characterizes the spread of infectious lesion with distinct borders. Acute focal pulpitis is considered the beginning of inflammation of the soft tissues in polovoy the camera. Its duration localized process lasts about 3 days, after which the pathological inflammation is converted to a diffuse form.

The inflammation is often diagnosed in place of cavities. Attacks of pain of short duration, lasting no more than 10 minutes and then subside. Patients with focal form of pulpitis often correctly indicate the dentist for a causal tooth, because the pain are clearly localized in nature. The main causes of focal pulpitis — caries, trauma to the pulp, infection of soft tissues in polovoy the camera. It is important to quickly and professionally to start treatment to prevent the running of the pulp and save the tooth.

Etiological factors

Common cause of focal pulpitis is an infectious nature. After contact with pathogenic or conditionally pathogenic microflora in the canal pulp chamber, the microorganisms begin active operations, causing the inflammatory process. Bacterial lesion gradually extends to the whole volume of the pulp, completely changing its structure and morphological structure. The main reasons include:

Trauma. Some injuries may contribute to the penetration of infection to the deep structures of the tooth. Infectious lesion gradually destroys the bone tissue of the tooth, spreading to the soft tissue. Chipped crowns, mechanical injury, any injury of the tooth, unprofessional action of the dentist at the opening of the cavity can all be the cause of subsequent pulpitis.
Exposure to toxic substances. Some dental materials in the wrong dosage, can cause burns of soft tissue periapical region of the tooth. For example, improper imposition of ARSENICAL paste. Many clinics have long abandoned arsenic due to the high toxicity.
The incomplete removal of dentin. In the treatment of the tooth doctor is forced to completely remove the affected dentin. Absolute removal allows you to eliminate the infectious focus, if possible, to preserve the nerve. If the dentin is not removed to the end, the infectious lesion easily spread throughout polovoy the camera.
A loose fit of the seal. The existence of clearance between the filling and the tooth there is a huge risk of infection inside the tooth.
The removal of casts. During the taking of dental impressions dentists use thermoplastic mass. Incorrect use can cause the burn effect.
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In General, the pathological process is a consequence of the lack of professionalism of the doctor, as well as a result of violation of technological process in the treatment of the tooth.

Symptomatic complex

Acute focal pulpitis can occur depending on the nature of the flow. Each patient experiences different intensity of symptoms. In the diagnosis of pulpitis dentists resort to the subjective and objective signs.

Subjective symptoms

Signs of the disease according to the patient can wear blurred, but the focal process, as a rule, the patient reliably detect a bad tooth and correctly describes your own feelings. Such include:

  • paroxysmal pain:
  • deterioration of health;
  • headaches;
  • sometimes fever;
  • swelling and redness of.

Pain is often worse at night. The attack lasts on average about half an hour. For focal pulpitis characterized by the absence of radiating pain.

Objective evidence

Visual inspection of the patient the doctor does not mark any changes on my face. When the oral examination of the patient revealed lesions carious lesions of the tooth. Among the main symptoms are:

  1. soreness in the sensing cavity;
  2. pain when exposed to cold, air;
  3. the lack of elektrovojvodina pulp;
  4. painless percussion (tapping).

In some cases, require additional research methods, which consist in the differential diagnosis. Such methods are necessary for accurate identification of the disease from other similar lesions of the pulp chamber.

Diagnostic measures

At initial diagnosis it is crucial to identify acute focal pulpitis from other diseases, for example, from acute and diffuse pulpitis, pulpitis chronic form of papillitis and deep caries. There are a number of comparative studies that allow you start directed treatment.

Unlike running caries

Of the common signs pay attention to the following criteria:

  • carious cavity is not included in the tooth cavity;
  • the pain is of local character;
  • exacerbation of pain during sensing;
  • painless percussion;
  • the lack of structural changes in the periapical tissues of the tooth.
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For pulpitis is characterized by pain when exposed to hot and cold environments, prolonged episodes of pain, the patient experiences unpleasant sensations when probing the cavity of tooth.

The differences from the diffuse forms

Of the common criteria are the following:

  1. pain from any stimulus;
  2. the increased pain at night;
  3. a deep carious cavity;
  4. the preservation of the integrity of the tooth.

The focal process, the more pain occurs when exposure to cold, and diffuse form under the influence of hot temperatures. Attacks of pain in focal pulpitis is much shorter than in the diffuse. The main difference focal from diffuse pulpitis is the absence of pain radiating.


Upon successful diagnosis, the doctor will decide possible treatment. Among known methods of therapy distinguish conservative (medical) and surgical methods. To treat the pulpitis it is necessary at the very beginning of its development, which will preserve the vitality of a natural tooth.

Conservative therapy

Treatment is possible with minor problems in the oral cavity of the patient. If the pulpitis is localized, does not show signs of spreading to the entire volume of the pulp, then it is permissible to use biological treatment. The basic algorithm is the following manipulation:

  • relief of pain;
  • cleansing of the cavity of necrotic dentin;
  • the opening of the dental cavity;
  • the imposition of antiseptic:
  • filling.

Often require the use of anti-inflammatory drugs (e.g., Life, Dical, Chalcedon). Drugs activates the regenerative processes in the tissues of the tooth, eliminate pathogenic microflora, stimulates the restoration of tooth tissue.

Conservative treatment there are some contraindications:

  1. allergic to dental drugs;
  2. multiple contraindications to regional anesthesia;
  3. diseases of the nervous system;
  4. diseases of the blood;
  5. family history of the patient;
  6. hepatic, renal failure.

All conditions can deteriorate under the influence of active components of the drug, which get into the circulatory system. For the recurrence of some diseases is quite insignificant dose of the drug for the deterioration of somatic condition of the patient.


Treatment requires a high professionalism of doctors, prestige of the clinic and high technology in the therapeutic approach.

Surgical treatment

Surgical treatment is indicated in advanced cases of pulpitis, when the pulp structure to save not possible, or when there is no possibility of traditional treatment. Surgery can be done with purulent or diffuse form of pulpitis. The algorithm of the procedure looks like this:

  • the introduction of painkillers;
  • the lower temperature (at higher);
  • the opening of the cavity;
  • the imposition of medicines;
  • antiseptic treatment;
  • setting temporary seals.
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Temporary filling allows you to monitor the success of treatment. If soreness does not occur and there is no any discomfort, then place a permanent filling. Usually a surgical technique performed in one visit. In rare cases, additional time is required to monitor the status of the patient (multiple visits).

Traditional methods

Despite the effectiveness of some of the healing recipes is to say that any alternative therapies have been successfully working on the background of conservative medicine. The use of decoctions of medicinal herbs, essential oils, lotions and ointments for a household of mouth will be ineffective in progressive pulpitis. Doctors recommend to use the decoction for rinsing after carrying out medical procedures as a natural antiseptic.

Any treatment should be agreed with the doctor. To continue maintenance therapy after treatment of pulpitis it is necessary to consult a specialist.

Complications and prevention

Complications of focal pulpitis develops very rarely. Another thing, if the pathological process moved into a purulent form. With the development of pulpitis possible extensive sepsis, which affects all organs and systems of the body. If relapses occur again and again, then tooth extraction is the only adequate solution. There are episodes of bleeding and swelling. The correct solution to medical tasks reduces the risks of complications, maintains the viability of the natural tooth. To prevent pulpitis it is recommended to conduct a number of preventive measures:

  1. timely treatment of caries;
  2. reaction to pain and discomfort;
  3. review dentist at least 2 times per year;
  4. exclusion of precipitating factors.

Often dental health is in the hands of the patients themselves. In all pathological entities in the oral cavity, the patient notices the signs and symptoms. Launched clinical situation in many cases is a consequence of the indiscipline of the patient, neglect of their own health. Timely medical intervention helps to preserve the natural beauty of your teeth for years to come.