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What Is Pulpitis?

Medically Reviewed by Melinda Ratini, DO, MS on May 19, 2021

Pulpitis can cause severe tooth pain and dental emergencies. It is caused by inflammation inside your tooth.

What Is Pulpitis?

Pulpitis happens when your dental pulp becomes inflamed. Your teeth have 3 layers: the enamel on the outside, the dentin that supports the enamel, and the dental pulp on the innermost part of your tooth.‌

This center part of your tooth is made of connective tissue, nerves, and blood vessels. It can become inflamed because of cavities or other dental health reasons. ‌

There are 2 types of pulpitis.

Reversible pulpitis. This type of pulpitis is the early stages of inflammation. It has limited inflammation and can be fixed by treating the tooth. 

Irreversible pulpitis. This is when the inflammation has completely damaged the pulp, which can’t be saved. 

Pulpitis Symptoms

The first sign of pulpitis is pain. The pain might be sudden, intense, and throbbing, or it may be dull and achy.‌

Symptoms of reversible pulpitis include:

  • Sensitivity to sweet foods or drinks
  • Sensitivity to cold that lasts only a few seconds
  • Sharp pain
  • Tooth doesn’t hurt when it’s tapped

Symptoms of irreversible pulpitis include:

  • Intense pain
  • Spontaneous pain
  • Sensitivity to cold that lasts more than 30 seconds
  • Sensitivity to heat
  • Pain when the tooth is tapped
  • Swelling around tooth and gums
  • Fever
  • Bad breath
  • Pain that moves
  • Trouble finding which tooth is causing the pain‌

As inflammation builds in your tooth, the pulp can die. This can happen with irreversible pulpitis and, once this occurs, the pain will stop. Your tooth won’t be sensitive to hot or cold anymore, but it might still hurt when it’s tapped. 

The tooth can then become infected and cause an abscess. Once this happens, the abscess will raise your tooth in the socket. It might feel higher than other teeth when you bite.

Causes of Pulpitis

There are many things that cause inflammation in your dental pulp. 

Cracked tooth. A fracture in your tooth can reach into your dental pulp, expose the dentin and pulp, and cause inflammation. This can lead to pulpitis and pain. You can get a cracked tooth from:

  • Biting down on something hard like an olive pit or a kernel of popcorn
  • Repeatedly chewing ice cubes
  • Old fillings or tooth restorations that weaken over time
  • Grinding your teeth
  • Injury to your mouth or tooth

Cavities. Cavities are the most common cause of pulpitis. These are holes in your teeth that are also called tooth decay. Cavities are caused by not brushing your teeth properly, bacteria, and lots of sugar. Tooth decay can spread deep into your teeth and affect your dental pulp and roots. 

Dental work. Sometimes you can get pulpitis after a filling, crown, or other dental work. This can cause reversible pulpitis that can be fixed once the original dental work is repaired. 

If you leave the problem for too long, it can turn into irreversible pulpitis. Major damage under the filling or amalgam can also cause irreversible pulpitis. 

Advanced periodontal disease. Periodontitis is a serious gum disease caused by a bacterial infection. It usually starts with inflamed gums that aren't treated properly. Periodontitis can cause bone loss, which can lead to pulpitis.

Treatments for Pulpitis

The treatment for pulpitis depends on the type and the cause. 

Reversible pulpitis. For reversible pulpitis, treating the underlying problem treats the pulpitis. Usually, this means removing any tooth decay and filling the tooth. If your tooth is cracked, they might also do a crown.

‌If the problem is from previous dental work, repairing the filling or other restoration can help. 

Irreversible pulpitis. If the damage is too extensive, your doctor will do a root canal. This procedure involves cleaning out all the dead pulp in your tooth and its roots and filling it. You will have a temporary crown for a couple weeks, which will be replaced with a permanent crown. ‌

If the damage is beyond a root canal, your dentist might pull your tooth. This is called a tooth extraction.

Medication. You can manage pain with pain relievers, non-steroidal anti-inflammatory drugs, or a tooth gel. Pulpitis can cause intense pain though, so the earlier you treat it, the better. Properly treating the problem will get rid of the pain.  ‌

Sometimes antibiotics are used, but there are different opinions on this treatment. Some experts say that pulpitis isn’t always caused by bacteria, so antibiotics shouldn’t be given. Others say that it should be used as prevention in preparation for other treatments. 

Pulpitis can cause severe tooth pain and can be a dental emergency. If your tooth is hurting, make sure to see your dentist right away. 

WebMD Medical Reference

Sources

SOURCES:

Cochrane Database of Systematic Reviews: “Antibiotic use for irreversible pulpitis.”

Dentaly: “What is Pulpitis? Types, Causes, Symptoms & NHS Treatment.”

Medscape: “Dental Pain.”

Merck Manuals Consumer Version: “Pulpitis – Mouth and Dental Disorders.”

Merck Manuals Professional Edition: “Pulpitis – Dental Disorders.”

NHS: “Toothache.”

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