What is pulpitis?
Pulpitis is an inflammatory disease that afflicts the dental pulp. It can be acute or chronic and its outcome can be necrosis of the pulp caused by the permanent interruption of blood supply.
The main cause of pulpitis is a bacterial inflammation that spreads from cavities to the dental pulp. However, traumas with fractures – which on occasion can expose the pulp directly to the attacks of bacteria – can be a cause of this affliction. Finally, chronic traumas such as bruxism (i.e. the tendency to grit one’s teeth when sleeping), unbalanced or incorrect chewing common with malocclusion, or excessive thermic stimuli can also cause pulpitis.
Types of pulpitis, symptoms and diagnosis
There are two types of pulpitis: reversible and irreversible.
Reversible pulpitis is generally distinguished by an elevated sensitivity to cold or sweet foods and drinks. It is also possible to feel discomfort or pain when bighting. Heat, instead, does not cause discomfort.
Generally there is no swelling with reversible pulpitis. Normally the tooth can still have a slight electric stimulus. Inside the dental pulp the inflammation isn’t as pronounced as it is with irreversible pulpitis, and the damage to tissues is minor.
Irreversible pulpitis instead produces pain that lasts several minutes after the stimulus and can even appear spontaneously. Patients may have difficulty in pinpointing the tooth causing them pain, even confusing the maxillary and mandibular arches.
In the case of an irreversible inflammation of the dental pulp, the tooth generally is highly sensitive to heat and very sweet foods. Chewing is also painful. Unlike reversible pulpitis, in this case it is often difficult to pinpoint the afflicted tooth because the pain spreads to the face, to the neck, to the temporal area, and to the ear. The pain is constant and deep, to the point that even sleeping is impossible because the supine position brings blood to the interested area.
To successfully treat reversible pulpitis is will be sufficient to remove the cause of the infection, which is often a cavity, carrying out a conservative therapy and desensitizing the exposed roots.
If there is no improvement after this first treatment, we will have to consider the possibility that the pathology has evolved into an irreversible pulpitis. In these cases, the irreversibly inflamed dental pulp will be removed, cleansing, disinfecting and hermetically closing the canal (endodontic therapy). Exactly like with other illnesses of the mouth and teeth, pulpitis can be effectively prevented with proper oral hygiene.
To avoid the onset of pulpitis it is necessary to prevent cavities. Thus we must avoid the formation and sedimentation of plaque.
Oral hygiene must thus be performed carefully, possibly after every meal, removing all food residue, which can favor the proliferation of microorganisms, with toothbrush and dental floss. The presence of anomalous bacteria in the oral cavity is in fact the main cause of plaque. And this, if it isn’t eliminated, can lead to cavities.
It is important to brush three times a day, brushing both the inner and the outer surfaces of the teeth delicately.
The toothbrush should have soft rounded bristles and should be changed every two months. The toothpaste should contain fluoride, which helps to strengthen the enamel and prevent cavities, and should never be abrasive so as not to damage the enamel.
Finally, it is fundamental to have regular check ups at the dentist’s every six months. Regular professional oral hygiene sessions should be programmed to ensure an accurate cleaning of the oral cavity and increase the effectiveness of daily hygiene.
All these actions combined will help prevent the infections that lie at the root of pulpitis.