Acute pulpitis: causes, symptoms, treatment, photos

Acute pulpitis brings great torment to man. Causes and clinical symptoms of this pathology is quite simple, but qualitative treatment only by the dentist. Presented in the article photo inflammation of the tooth nerve will help you better understand the entire therapeutic process.

The root canal is filled with soft texture, has a rich innervation and blood supply, it is for this reason pulpitis pain is so intense and exhausting. Delayed elimination of source of infection the tooth cavity not only leads to inflammation of the pulp, but also can spread to tissues surrounding the root.

Acute pulpitis: what is it?

Acute pulpitis is called inflammation of the neurovascular bundle of the tooth, characterized by:

  • sudden onset;
  • paroxysmal flow;
  • severe pain, worse at night.

History of the disease has several clinical forms. The degree of structural changes depends on the involvement of the pulp that may be manifested by redness or total destruction of the morphological elements of the content of cavity of tooth.

Connective tissue inner structure is divided into crown and root, and what the amount of pulp will affect the infectious lesion depends on its reversible changes that allow regeneration, or a radical treatment.

Related article: what is chronic pulpitis and how to get rid of it?


Prerequisites, why develop acute pulpitis, a few, but they all boil down to the fact that the changes lead to the development of inflammation richly innervated fibrous trunk.

The main causes of disease:

  • the carious process is the most common culprit for the development of pathology of the pulp. Cariogenic microflora through microscopic tubules in the dentin is able to penetrate into the inner part of the tooth and cause inflammation there;
  • mechanical injury – a violation of the integrity of the crown by receiving the blow to the jaw, falls or otherwise causes to be violated protection of the pulp and part of her getting naked. Even the slightest touch to a gaping horn neuro-vascular plexus may cause bouts of unbearable pain;
  • iatrogenic injury to the pulp can occur because of medical intervention. The preparation of caries without water and air cooling, etching a special compound without observing techniques, too deep extensive removal of tissue without taking into account the anatomy of the pulp – all of which can lead to inflammation;
  • located close to the source of infection when close to the problem tooth is a pathological focus (sinusitis, periodontitis, the affected wisdom tooth), that pathogens can spread via the blood or lymphatic vessels and lead to changes in Popovoj the camera;
  • penetration of bacteria through the periodontal pocket – in diseases of the marginal gingiva germs get into broken dentogingival connection and enter apicalnam hole, which can cause periodontitis, or retrograde pulpitis.
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If we talk about the nerve inflammation in children, its main cause is considered to be an infection. Baby teeth have a small thickness of the hard tissues, so the carious process quite quickly spreads deeper into why there is an infection of the neurovascular bundle.


Signs of pulpitis in the acute form pronounced, so confuse it with other diseases quite difficult. Pain when inflammation of the nerve has the following characteristics and distinguishing features.

  1. Acute – unpleasant feeling is so strong that sometimes its unbearable to endure.
  2. Spontaneous – feeling, regardless of exposure to external irritants and as suddenly subside.
  3. Night the discomfort from disturbing the tooth increases in the evening or after bedtime.
  4. Attacks of pain has a fluctuating course characterized by the presence of «light» and «dark» intervals. During the initial stage of development of the disease of pain-free intervals are long, can reach several hours or even days.
  5. The increasing of stimuli – mechanical, chemical and thermal effects cause an increase in the intensity of attack, with the pain persists after the irritant source is removed.

Photos and x-rays


To facilitate the diagnosis and choice of therapeutic methods was developed several sistematizatsii that produce morphological and clinical types of pulpitis. Currently widely used two classifications: Gahungu and ICD-10.

  • focal serous pulpitis partial classification Gopura, starts a sharp attack of pain for no apparent reason, while the large area covered by tooth nerve inflammation, especially some «light» intervals. Soreness after cessation of exposure to the stimulus disappears for a short time, but not simultaneously, as with the average form of tooth decay. Infectious disease is preceded by a carious process in which pathogenic germs in the dentinal tubules penetrate into the inner structure. A variation of the process is considered to be a traumatic lesion occurring in case of accidental opening of cavity of tooth during treatment of dental hard tissues in the treatment of deep caries;
  • diffuse serous pulpitis – General classification Gopura, inflammation covers the coronal and root pulp, at the same time developing its swelling and redness. Increasing the pressure inside the chamber causes compression of the nerve trunk and provoke unbearable pain. Once the liquid enters the channels of the dentine, the voltage decreases and comes painless period. Different types of stimuli lead to a long and persistent strengthening of the attack;
  • purulent pulpitis in the process of accession of putrid infection occurs the melting of the fibrous tissue. When this occurs, a throbbing pain, aggravated by hot food and the change of body position from horizontal to vertical. «Light» the time between the spasms is almost absent.
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How diagnose?

To confirm the diagnosis the dentist performs the examination, during which the identified characteristic of the acute form of pulpitis features:

  1. Visually defines a cavity, deep, filled with infected with the affected tissue that has changed color.
  2. Sensing causes a sharp pain across the bottom (hyperemia of the pulp) or at a single point.
  3. Message polyarnoi camera is either absent or is a small hole with a gaping horn neurovascular fiber.
  4. Percussion in a vertical plane usually does not cause increased pain attack.

To rule out other dental disorders the doctor should conduct a differential diagnosis. The comparison is performed with different nosological forms:

  • hyperemia of the nerve – resembles a deep cavity, there is a short and bystroprokhodaschee reaction to different types of stimuli;
  • papillitis – inflammation of the interdental papilla, while it is swollen, red, may bleed, and the presence of carious cavity in the adjacent tooth is not required;
  • acute apical periodontitis – pain is aching in nature, increases with pressure, a feeling of «bulging» of the tooth, the intensity of the attack does not depend on the time of day;
  • neuralgia of nervus trigeminus – a shooting pain appears by touching the face, talking or eating or when touching the starter zones.
  • sinusitis is characterized by nasal congestion and suppuration of the moves a violation of the General well-being, headaches, hyperthermia;
  • alveolus pain – alveolitis develops with the infection of recently hole of an extracted tooth.

Acute pulpitis and methods of treatment

At the first sign of severe pain in the tooth should seek help from a professional, because to treat acute pulpitis should only dentist. Depending on the clinical picture, the doctor selects the appropriate treatment method:

  • biological method – used when a partial involvement of the pulp in the process or when accidental exposure. It is important to observe the time frame after a careless opening, because late treatment will not bring results. Gaping at the camera angle of the tooth is overlaid with calcium material is fixed and sealed with a temporary filling. It promotes the development of substitution of dentin and closure of the openings;
  • amputation is partial removal of the coronal nerve, used in focal serous pulpitis in pediatric practice. The event is aimed at preserving the viability of the apical area, what you need to further complete the formation of the root and closure of the sprout area;
  • extirpation – the complete removal of the diseased pulp, followed by antiseptic treatment of the canal and filling.
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To cure the pulpitis in a home environment is impossible, however, to cope with unbearable pain to dental care will help you receive pain medication. Proven effective drugs in the fight against dental pain the following tools.

  1. Nise.
  2. Ketorol.
  3. Ibuprofen.
  4. Nimesulide.

The use of various rinse oral cavity will not bring substantial relief of the condition, so you should not self-medicate, because the pulpit is not the disease will help where traditional methods.

Video: what is the pulpitis and how to treat it? Meets the dentist.

Further questions

► Code for ICD-10

Diseases of pulp and oculocardiac tissues are located in the K04 category, wherein the encrypted code pulpitis K04.0. Among the varieties it is isolated hyperemia or initial form (K04.00), acute stage (K04.01) and purulent (K04.02). In addition to these types, separately encode changes necrotic pulp (K04.1) and degeneration (K04.2)