Dental pulp diseases: causes, types and treatments

Poor oral hygiene can lead to pulp diseases that require root canals, or worse. Learn about the types, symptoms, and treatments for oral pulp diseases.

What is pulpitis?

     Pulpitis or inflammation of dental pulp is the commonest cause of dental pain.

Causes of Pulp disease

     Most pulpitis is primarily as a result of dental caries secondary to bacteria invasion of dentine and pulp tissues.
However, pulpal changes may occur in early caries limited to enamel alone as white spots. Bacteria invasion in the absence of caries occur in tooth fracture or as a result of bacteremia. And if pulp diseases aren’t properly managed, you can lose your teeth.
This is termed anachoretic pulpitis which accounts for insignificant numbers of pulpitis. Microbes are significant in Aetiology of pulpitis in that surgical pulps exposure in germ-free animals did not result in devitalized pulp or Periapical infection even in gross food impaction, in contrast to conventional animal’s that rapidly develops acute pulp necrosis.
pulp diseases
Source: ” Freelance dental nurse” – under creative commons license

pulp diseases may arise due to

  • Chemical irritation of the pulp – in pulpal exposures to which irritant medicament is applied.
  • Intact pulp beneath deep or moderate cavity with irritant filling materials. There may be penetration to pulp via dentinal tubules. The pulp may, however, respond by forming reparation dentine.
  •  Severe thermal changes may produce pulpitis which is most common on tooth with large metallic restoration especially with inadequate insulation between the material and pulp.

Heat and more particularly cold, are transmitted to a pulp, producing pain and on prolongation actual pulpitis.

Summarily, pulpitis can result from the following:

  1. Dental caries
  2.  Traumatic exposure of the pulp during cavity preparation.
  3. Fracture of tooth crown.
  4.  Thermal injury arising from operative procedures.
   5.  Chemical irritation due to irritating restorative material.
   6. Crack – Tooth syndrome – splitting of a tooth under masticatory process (usually premolar.)

Classification of pulp diseases

There are several different pulp diseases, including:
Can be classified into acute and chronic pulpitis. May also be classified into partial, subtotal, or Total. Partial pulpitis occurs in confinement to a portion of the pulp. If most pulp tissue is diseased. Generalized pulpitis results.
Presence or absence of direct communication between the pulp and oral environment may give rise to open or close pulpitis
 The clinical differences result from the presence or absence of drainage of inflammatory fluid.

Focal reversible pulpitis ( FRP)

  This is the earliest form of pulpitis which is mild and transients. It is pulpitis which is located to the pulpal end of irritated dentinal tubules.

Clinical features of Pulpitis

   Sensitivity to thermal changes especially cold, which disappears on the removal of an irritant.
There is a response to electric pulp tester at a low level of current indicating lower pain threshold than adjacent normal teeth.
   
It is seen in deep carious lesion, large metallic restoration especially without isolation or restoration with defective margin.

Treatment of pulp diseases

  1. It is a reversible condition; if irritant is removed before severe damage.
  2. The carious lesion should be exercised and restored. Also, the defective filling should be replaced.

What are the Symptoms of pulp diseases?

Depending on the type of pulp disease, symptoms may vary in intensity and can include:

  • pain on eating or drinking hot or cold food/drinks.
  • a dull ache at the jaw.
  • pain which is spontaneous and throbbing.
  • tenderness at the tooth on touching and biting.
  • pain which may interrupt sleep.
  • pain which may be referred to head, temple or ear.

Prevention of pulp diseases

The best way to prevent toothache is to prevent pulp disease. Decay can be prevented by,

  • A sensible diet –  limit snacking in between meals, and the consumption of refined carbohydrates eg sweets, cake, ice cream.
  • Brushing your teeth with fluoride toothpaste twice daily
  • Flossing at least once a day
  • Regular visits to the dentist for tooth checkup.
Read also:  
Reference
Pulpitis ( reversible/irreversible) – jcda
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