Chronic pulpitis: symptoms and treatment

Chronic pulpitis is considered to be a complex form of disease, which can occur without the appearance of characteristic symptoms. This causes problems in early detection and treatment of disease, which often becomes the reason of development of many complications. In chronic pulpitis there is a gradual defeat of the inflammatory process of the soft tissues of the tooth, and this pathology can take a long time.

Characteristics of the disease

The term «pulp» refers to inflammation of the neurovascular bundle, which is localized in the coronal portion of the tooth. In a situation when the pathology occurs in the acute stage, it is possible to stop the further progression of disease and restore a tooth without removing the nerve. Chronic pulpitis causes the development of irreversible forms of pathology and the inside of the molars there is slow degeneration of the pulp.

The patient formed fibrous tissue, occurs after the necrosis or the proliferation of the neurovascular bundle to fill the cavity. Medical practice shows that this disease is diagnosed in a large number of people seeking help to the dentist. Many patients come for consultation to the dentist not because of strong pain, and in fear of losing the tooth. Mainly the development of a chronic pulpitis is considered to be the result of not cured acute form of the disease, but in children it can appear without it.

The reasons for the development of the disease

For the chronic form of the disease is not accompanied by the appearance of characteristic signs. This pulp can appear in a patient as a separate disease, but is often a consequence of the acute form of the disease. Experts say that the transition of the disease into a chronic form is observed after 12 weeks after the start of its development.

Predominantly chronic pulpitis develops on the background of many infections and toxins that they secrete. To prevent many complications you need to diagnose disease and make treatment.

To cause the progression of pulpitis is capable of the following factors:

  • the formation of the cavity, which gets the food, in fact it becomes an ideal environment for bacterial;
  • chipped molar;
  • conducting poor quality of dental treatment;
  • the appearance in the mouth of apical openings, which come in pathogenic microorganisms;
  • the Erasure of the crown, which provokes the appearance of a pathology.

Sometimes cause pulpitis is capable of various ENT disorders like sinusitis. Such factors becomes a trigger for the development of acute pulpitis, which slowly transformed into chronic.

Types of disease

Experts identify the following chronic forms of pulpitis:

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Chronic fibrous pulpitis. Mostly begins its progression on the background of acute. For this pathology there is the appearance of characteristic symptoms and the primary among them is pain. Mostly it occurs when exposed to the molars of thermal stimuli, especially cold. After irritants cease to affect the tooth, the discomfort disappears and appears in the focus of a particular tooth. Upon inspection diagnosed extensive carious cavity with the stored pulp.
Chronic hypertrophic pulpitis. Appears as a result of the connection of carious cavity with polyarnoi camera. Mainly by center cavities becomes the chewing surface of molars, so the process of eating is considered one of the strong stimuli. The main feature of this form of disease becomes the bleeding that occurs while eating.
Gangrenous form. Occurs as a result of a running of purulent chronic fibrous pulpitis. At this disease occurs gradual subsidence of the pulp at the opening polyarnoi camera, you can see the grayish color. The main symptom in this form of the disease is considered severe pain, the localization of which becomes the domain of one specific tooth. During the inspection the technician identified an extensive cavity affected by the carious process with the opening of horn of pulp.

Experts identify such pathology, as a exacerbation of chronic pulpitis. The treatment of this pathology can be performed through conservative therapy or by surgical intervention. In most cases, the aggravation occurs when fibrous and gangrenous form due to the following reasons:

  • reducing the protective functions of the body;
  • severe hypothermia;
  • the progression in the body of infectious pathologies.

Each of the forms of chronic pulpitis causes the development of certain symptoms and needs to be addressed.

Symptoms of the disease

Often in case of chronic pulpitis symptoms often do not appear. Chronic fibrous pulpitis always causes the appearance of severe paroxysmal pain, which react to thermal stimuli. A characteristic feature of this form of the disease is considered to be postponed of appearance and disappearance of pain syndrome, i.e., unpleasant sensations do not disappear after termination of the stimulus, and after a while. In addition to pain attacks, the patient may complain of the appearance of the affected tooth feel.

With the development of chronic hypertrophic pulpitis is usually pain syndrome does not occur. In most cases there is a growth in the outside tooth tissue that gets injured and becomes the cause of bleeding when eating. Often there is severe pain with pressure on the tooth or in the process of chewing.

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For chronic gangrenous pulpitis tend to have more pronounced symptoms. Patients noted the appearance of aching pain that occurs when the influence on the tooth to different stimuli. Even after their disappearance for a long time, the pain syndrome disappears. In this form of the disease starts putrefactive decomposition of the pulp that causes mouth odor. Observed staining of molars in a grayish color and dull the enamel.

In a situation when acute chronic inflammatory process, pain can develop without the influence of the stimulus. Mostly this pathological process develops at night, and pain long and happy irradiiruet in the trigeminal nerve.

Diagnostic methods

When you visit a dental office the doctor asked the patient the nature of the pain that was bothering him. In addition, the specialist draws attention to the duration and severity of the disease and the presence of acute pain episodes in history. Usually diagnosis of the patient is carried out using techniques such as inspection of the patient’s teeth and probing of the pulp.

When the form of pathology during the examination revealed extensive carious cavity, which communicates with polovoy camera. When probing, the pulp does not cause pain and discomfort and no bleeding. In that case, if revealed hypertrophic pulpitis, there is bulging of the granulation tissue from the cavity.

When radiography fails to identify changes, which are presented in the form of expansion periodontal cracks or rarefaction of bone tissue. It is important to differentiate chronic pulpitis acute stage of the disease, deep caries and acute phase of chronic periodontitis.

Features of treatment of the disease

Dentist first drew attention to the General condition of the patient. In fact, the treatment of the chronic form of the disease is not possible with conservative methods. In children the elimination of this disease is somewhat different than treatment for adults. This is due to the fact that the body of children is still too weak for the application of those or other drugs. With extreme caution the treatment of chronic pulpitis in the elderly, because some painkillers can affect the cardiovascular system.

In most cases, chronic pulpitis treatment is by surgery, but the course of the operation is determined by the form of the disease.

When the diagnosis in a patient of fibrous pulpitis treatment is directed primarily at the removal of the affected part of the pulp. In that case, if the pathology affects a very large area, it is possible the complete removal of dental pulp. The patient entered pain medications, and begins the operation itself, which includes the following steps:

  • the autopsy the cavity of the affected tooth and remove all accumulations along the affected tissues;
  • implementation of antisepti and deletion of partitions, through which the pulp is separated from the cavity of the tooth;
  • resection crowns and root canals extension that allows you to get rid of the fibrosis;
  • re-processing means of anti-inflammatory action and sealing of the tooth first temporary and then permanent.
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Treatment of hypertrophic pulpitis aimed at the partial or total deliverance from the pulp. The operation is performed using General or local anesthesia and it depends on the extent of the inflammatory process. The surgery is performed on an identical scheme, which is used when removing the fibrous form of the disease. The only difference is the fact that hypertrophic form needs a thorough cleaning and filling of root canals.

The elimination of the gangrenous disease is carried out only by an experienced dentist, and the procedure includes the following stages:

  • the introduction of anesthetics in the area of inflammation.
  • removing the coronal portion of the pulp and the expansion of channels with the aim of getting rid of the remaining inflamed pulp;
  • performing electrocoagulation, there is cauterization of the nerve, and the cavity thoroughly dried
  • the specialist is the imposition of antiseptic dressings and filling of root canals.

Treatment of pulpitis in children is slightly different, because the connective tissue is still quite loose, and the mineralized dentin is not enough.

Prevention of disease

Early detection and effective treatment of the disease allows you to save the molars for a long time. In advanced forms of of pulpitis may cause various serious consequences, for example, osteomyelitis, suppurative periostitis and periodontitis.
The most effective way to prevent disease is the prevention and timely suppression of caries in children. When a toothache is not worth it to endure because it may indicate inflammation of the pulp. To avoid development of a chronic pulpitis is possible with regular visits to the dental office and the proper care of the teeth.