Pulpitis of the tooth what is it: classification, symptoms and treatment
Probably, every adult knows what a pulpitis of the tooth. The name may seem unknown, but the condition familiar. Quite a few have experienced terrible intolerable toothache, especially at night, not allowing not to sleep, even to lie. Pulpitis of the tooth, what is it? Is inflammation of dental pulp that produces its swelling. Classification of pulpitis varied. They can be acute and chronic.
For it is the pulp of the tooth. Each inside tooth has a cavity. It called for another polyarnoi camera. From the title it is clear that it is there and is our the pulp of the tooth. She is a bundle consisting of blood vessels and numerous small nerves. Thanks to her, is nutrition dental crowns and roots. They have the natural Shine and color.
Causes of pulpitis varied. But the most common is getting an infection via a cavity. When a dental caries and the patient in time to avoid seeking dental care, it deepens. And there’s a wall between the carious cavity and polyarnym space becomes very thin or disappears altogether. All the bacteria and germs get into the tooth pulp. There occurs inflammation, resulting in neuro-vascular bundle swells. Due to the pressure of the walls of this flesh and there is pain.
Pulpitis has other causes. It can develop due to retrograde infection, that is, when she gets through the apical hole of the tooth root. This may be due to somatic infections, when it gets through the blood. Sometimes when there is deep, infected periodontal pocket, which is formed in violation of the integrity of the connection of the tooth with the gums due to periodontitis. But this way pulpitis occurs very rarely.
The manifestation of inflammation of the dental nerve
The clinical picture depends on the classification of pulpitis. The symptoms are similar and at the same time differ. In any case, there is pain. To understand in more detail you need to know what forms there are.
What is pulpitis, classification of pulpitis:
- Acute focal and diffuse;
- Chronic – fibrotic, hypertrophic and gangrenous;
- Aggravated chronic.
Based on the name of the acute forms occur acutely and spontaneously. Spontaneous pain, but may also arise under the action of irritating external factors. Especially in contact with hot food. In focal option pain is localized in one tooth and the patient definitely can point him out. During the inspection revealed carious cavity, perhaps her message with the pulp of the tooth. Percussion (tapping) is negative. The conducting probe is painful in one point. In the gums no change.
Diffuse is more vivid symptoms of pulpitis. In this case, the pain can radiate, i.e. to surrender to the other jaw, adjacent teeth and even ear. Wear the same spontaneous character, aggravated at night. During the inspection it happens, that even a touch to the tooth can cause terrible pain. Probing is painful on all bottom of carious cavity. Tapping can react. The mucous membrane is normal.
Chronic in remission can cause discomfort only due to the presence of the cavity and leakage of food debris. Pain does not happen. To distinguish them from each other helps nature of the cavity and pulp of the tooth. When fibrous nerve bundle is replaced by fibrous tissue. When gangrene occurs necrotization — necrosis of the pulp, in particular of the crown. Often, the root remains alive, especially toward the tip. For hypertrophic characterized by the growth of granulation tissue, which can «stick» of the dental crown.
All symptoms negative if no aggravation. Otherwise they are the same as in the acute form, but less bright. It also happens that pulpit immediately goes into chronic. The patient may not know that he had an inflamed tooth nerve. This creates the risk that also not noticing this inflammation may go to the root tip.
These are the main types of pulpitis, but there is also traumatic. In this case, the pulpitis has causes associated with simultaneous opening. It occurs in bruises, chipped, accidental exposure of the nerve during the dissection. Traumatic pulpitis symptoms is the same as in the acute species. The characteristic may be, upon inspection of the purchase of the pink color of the tooth, as a result of bleeding in it.
Additional methods of examination
To determine the presence of inflammation in the dental pulp, mainly used in thermal methods and EDI – electroodontodiagnosis. As a first option, apply cold water with a pistol and a dental spatula or stopper heated on the fire. From the hot slowly the pain increases, becoming more intense. Applied to the aching tooth and watch the reaction. EDI is used to determine elektrovojvodina pulp. Normally it is 2-6 mA. With pulpitis, it can reach 20 mA.
You can do the x-ray sighting to a differential diagnosis of periodontitis. Unlike the latter, the x-ray signs of any of pulpitis of the tooth will be missing. A slight, barely noticeable rarefaction of bone tissue in the apical hole. But this happens very rarely. These are the main symptoms of pulpitis that you should pay attention to.
Each person will be useful to know the characteristics of pulpitis, in order to seek help:
- Spontaneous sharp shooting pain, worse at night;
- The symptom of pain from hot;
- Irradiation in the neighboring area;
- Increasing pain sensation when injected stimulus into the cavity and does not pass after its removal.
In the presence of at least one of the following points should be suspect of any tooth pulpitis and go to the dental clinic to avoid complications.
The possible treatment of the inflammatory process in the pulp
The symptoms and treatment also vary, and the classification of pulpitis. The question is what options can be in addition to removing the nerve? In fact, they are not similar like in fashion and in stages. A lot plays an important role and which tooth is affected. How many channels it has, how they form, etc. How to treat pulpitis in one session? And is it possible?
Still, many worried about does it hurt to treat pulpitis of the tooth? Every day I try to make sure that the patient did not feel pain during any manipulation. Including the treatment of pulpitis. In any case, before any intervention is conducted anesthesia. So patients will hurt only during the injection for a few seconds.
The preservation of the tooth nerve with pulpitum treatment
What methods of treatment of pulpitis exist? There is a way in which you can save the life of the pulp partially or fully, and when you want to remove it. Is it possible to cure pulpitis without removing the nerve? It is possible, in some cases. It is focal in acute and traumatic. This method is called biological. The imposition of glucocortico-antibioticului pasta with its subsequent replacement by calcium hydroxide. Very important are speed of preparation and drug treatment. You need to drill at a low speed drill so as not to cause overheating and more irritation on the nerve. To handle only weak solutions of hydrogen peroxide and chlorhexidine.
Pastas are layered under a temporary bandage of the dentin. During this time, it is necessary to observe the patient. To find out if there are any concerns and whether there were changes in the tooth and around. If everything is in order, the temporary dentin is replaced with a permanent seal. But this method is no longer used because of its inefficiency. It is very difficult to save the nerve in the inflammation.
There is still a vital amputation of the pulp, which is used in the same cases, and biological and inefficiency. This method can only be treated premolars and molars. In this case, the crown is removed the pulp of the tooth, but it remains in the roots. Widen the mouth and remove sawdust impose dentin with calmasino, top cincauhangus paste and close the dentin-paste. In the absence of pain, the permanent filling is in a month.
How to treat pulpitis surgically? So called because of the nerve bundle. It can be done in two ways: vital and devital. In the first case, the nerve is alive and it is removed under local anesthesia. In the second case, it is first devitalizing, then the next time you visit are the remaining steps.
The stages of treatment of pulpitis vital way:
- Anesthesia local;
- Dissection of carious cavity, followed by opening the tooth and removing the coronal portion of the pulp;
- The extension of the orifices of the root canals;
- Removal of the nerve of them;
- Instrumental and medicamental processing of channels;
- Their drying and filling;
- The imposition of the restorative material.
This method is used when a treatment of pulpitis of permanent teeth. For time, this method is unacceptable. In other cases, conduct devital extirpation, i.e. the removal. The same stages of treatment of pulpitis, since the removal of the nerve. On the first visit carried out cavity if polarna camera is not opened, it is opened spherical boron number 1. This place impose arsenic paste using a dental probe. The top must be closed with a cotton swab and then dentin to arsenic is not leaked and did not get on the mucous membrane. So you need to go from two days to a week, depending on the duration of action of arsenic. Then the treatment of pulpitis such steps as the previous one.
The treatment of front teeth
From the front of the group, the carious process often affects the upper Central and lateral incisors. Canines due to their structure are not affected, they are more massive. Lower incisors due to the heavy wash of saliva, which contains a lot of minerals, is also not affected. But they have a high probability of deposition of dental calculus. Often there is a traumatic pulpitis of anterior teeth. This may be due to injuries because they are more prone to being dropped or sport activities etc. are Also in the prosthetic metal structures. They require heavy turning, the tooth tissues become thinner and the nerve is more responsive to external stimuli. So I prefer to delete it right away, then again not to alter the work.
Front teeth are easier to treat due to the fact that they have only one channel. To find it is not difficult, because the cavity smoothly into the root canal. To remove the nerve can be directly with the crown and root parts. And canal front tooth is wide enough, so with his passing and purification becomes easy. This also applies to the filling. Often sealed with a paste and gutta-percha pins. Then you can immediately seal a permanent material. Treatment of pulpitis of anterior teeth seldom with extermination.
Complications of pulpitis and its treatment
Pulpitis of any kind can lead to serious complications. As mentioned above, it may be periodontitis. Is inflammation of the periapical tissues with the formation of pus. If this pus has nowhere to go, result in periostitis or, in other words, flux. In the best case you will have a fistula and through it will come out pus. If the fistula will not purulent inflammation may go into the jaw bone and raises the osteomyelitis. But this is not the worst, could develop blood poisoning. To this was here before, it is better to ask for help, despite his fear.
A complication in the treatment can be the removal of the filling material over the top. In this case, the patient will be observed postproduzione pain when biting. But these feelings pass in a few days. Can also develop ARSENICAL periodontitis. It develops when the tooth cavity is greatly opened and the pulp through the arsenic gets into the periapical space. In this case, pus may not be formed, but the pain will periodontitis. To avoid this in such cases it is better to remove a live nerve under anesthesia.
To avoid possible complications, and the occurrence of inflammation, it is necessary to know, first and foremost, signs of pulpitis of the tooth. As soon as there is tooth pain, you must immediately go to the dentist for help. Even if one symptom is absent, but noticed tooth decay, also should not waste time. If for some reason it is impossible in the near future, then in any case not to apply the advice of grandmothers, especially warm place where it hurts. From heat blood vessels dilate and this place to flow more blood, and this leads to swelling. Well, and subsequently, the pain becomes more intense, may develop purulent process. Rinse you can try, but in the pulpit they won’t help.
If people stopped being afraid of the dental office as a child, would not perceive as something unpleasant and bad, perhaps there would be no such serious damage the life of the teeth. Many still believe that they will be hurt, or be treated inappropriately, perhaps the doctor will be competent enough and do something wrong. In such cases it is better to go for professionals who are ready to answer any of your questions.