Pulpitis: Symptoms and Treatment

Update: December 2018 Tooth is a full body,
consisting of 3 layers arranged one after another. Most
the surface of them is represented by enamel – the most durable structure
our body. Next up is the special substance dentin, by
strength is not inferior to the bones of the human body. Most
deep, under these shells is placed the pulp. This is a whole complex
soft tissue with nerves and vessels that nourish and support
normal organ metabolism.

ATоспаление пульпы вызывает ряд ярких симптомов, так как эта зона
blood supply is good, so pathological processes are always
flow very actively. And due to the large number of pain
receptors, the disease does not allow itself to forget even at rest.
It is possible to get rid of discomfort only with timely treatment.
pulpitis of the tooth, and in order to hold it you should know the reasons
typical manifestations of pathology.

Forms of the disease

Pulpitis is an inflammatory reaction that has several
options flow. AT первую очередь, следует выделять острую и
chronic forms of pathology. If signs of illness have occurred
suddenly and before the patient did not feel similar symptoms in the tooth,
most likely it is a manifestation of an acute process. AT зависимости от
характера воспаления он может be:

  1. Serous – развивается только при отсутствии инфекции, когда
    most symptoms are due to edema and increased
    blood vessels of the pulp;
  2. Purulent – проникновение бактерий к глубоким слоям является
    necessary condition for this type of disease. He is more
    heavy because germs can release their toxins into the blood and
    penetrate there by yourself. This process leads to deterioration.
    general well-being and signs of intoxication.

With затяжном течении патологии, изменения в мягких тканях зуба
take a persistent character. Constant impact of pathological
processes on normal cells leads to their changes, often
irreversible. ATозможны следующие варианты хронического пульпита:

Hypertrophic (granulation)

This is a special type of inflammatory reaction that causes
excessive proliferation of special connective tissue with large
the number of small vessels. Over time, she starts
�“Bursting” the body from the inside and damage the surface layers;

гипертрофический (грануляционный) пульпит

Fibrous

AT этом случае, поврежденный участок замещается коллагеновыми
fibers, fibrocyte cells and other connective tissue
components. Most благоприятная форма из всех видов
chronic process;

фиброзный пульпит

Gangrenous

This is the complete deadening of the feed layer, which is not accompanied by
only local symptoms, but also the general response of the body to this
process. Severe version of the disease, requiring adequate and
timely intervention of the dentist.

гангренозный пульпит

Manifestations of the disease and the nature of tissue changes at each of them
significantly different, therefore, approaches to therapy will be
are individual. Very important when suspicious symptoms appear.
do not engage in self-treatment, and turn to
a qualified doctor. The sooner this is done, the lower
there will be a chance of complications and a protracted form of the disease.

Withчины

In most patients, symptoms of pulpitis occur after
partial destruction of the protective layers of the tooth (enamel and dentin).
Open communication of soft tissue and oral cavity is inevitable
leads to inflammation. Withчиной его возникновения могут стать
Various factors of which the following are most often encountered:

Withчина Development mechanism Characteristic version of the disease
Caries Poor oral hygiene and microbial action –
the most significant factors in the development of the disease. Essentially, caries is
just a “hole” in the surface of the dental shells, through which
microbes penetrate the organ. Reaching the blood vessels,
bacteria provoke an inflammatory reaction;
Acute Purulent
Injury Often the cause of the pathology becomes cleavage, contusion, fracture or
other mechanical effects. It may cause
significant damage to the pulp, which will lead to its inflammation,
without the action of harmful microbes;
Acute serous
Temperature exposure Even the most durable structures are sensitive to sudden changes.
temperatures. Under the influence of this factor can not only
damaged surface layers, but also deep;
Inadequate Dental Intervention It often happens that after treatment for
caries or when installing a new crown, the patient appear
signs of inflammation. Due to technical error, the dentist
soft tissue can be injured, resulting in
patient pathological symptoms.
ATозможны оба варианта. For example, when incomplete closing
carious cavity there is a risk of infection by microbes and
formation of purulent process. AT случае механического или
thermal lesion develops serous inflammation.

Chronic forms can occur if left untreated
of the above reasons. As a rule, 1-2 is enough for this.
недели «перетерпеть»  болевые ощущения, после what is spicy
the process takes a protracted course. That is why, doctors
It is recommended not to postpone a visit to the dental office.

Symptoms

Despite the fact that each form has its own clinical picture,
manifestations of the disease are limited to four symptoms. Defining them
character, and carefully analyzing the patient’s complaints, you can
establish a preliminary diagnosis.

Pain

This is the main symptom that the patient pays attention to when
any kind of pathology. In the acute process, the tooth hurts very much
intense, unpleasant sensations are aggravated by any influence:
while probing or chewing food, eating
cool or heated food / liquid, even when irrigated with water
25-28оС («комнатной температуры»).  They are long
time saved, even with the elimination of provoking factors.

Treatment of chronic pulpitis is often delayed due to
minor pain sensations. As a rule, they arise only
with strong stimuli such as hot or cold
food (especially when the temperature drops in the mouth). Pain
has a nagging or pulling character, is expressed slightly and
lasts quite long (several hours).

This symptom can be more accurately assessed using the table located
below. It will not only distinguish between acute and chronic forms,
but also suggest the exact version of the disease.

Pain description Pathology option The nature of the pain When does it occur? Where does the pain in the tooth give up? How much does a symptom persist?
Serous Very intense; acute, “piercing character.
The duration of the attack is about 30 minutes.
Under the action of various factors (temperature change,
palpation, eating, etc.), intensified at night.
As a rule, there is no irradiation. Not more than 2 days
Purulent The character is similar to the serous variant, but the painful attack
Lasts much longer (at least 2 hours)
Spontaneously, but aggravated by stimuli. Across the half of the face, from the side of the affected tooth. 3-10 days
Hypertrophic Aching pain, low / medium intensity. Its duration
different (from 10-20 minutes to an hour).
Only under the influence of irritating factors Irradiation is not. From a few weeks
Fibrous
Gangrenous Unpleasant sensations were previously, but with the development of this form of pain
disappears (since all the nerves died).

Although this symptom is the main manifestation
disease, should take into account its other signs. This will allow
suggest a correct diagnosis after the usual collection of complaints.

Malaise and fever

Their occurrence is almost always associated with infectious
process in the body. In this case, it can only occur
with two types of pathology – acute purulent or chronic
gangrenous pulpitis. The main cause of the disease
are bacteria that release their toxins into the bloodstream or
penetrating it yourself. The result is a development
intoxication and characteristic symptoms (fever,
decrease in working capacity and appetite, weakness, etc.).

Unpleasant smell when breathing

Inflammation of the pulp may be accompanied by this symptom only in
one case – with the active work of anaerobic (airless)
microflora. This is a specific type of bacteria that often causes
gangrenous variant of the disease. The appearance of stale breath when
regular oral hygiene and the absence of intestinal diseases – a reason
suspect chronic inflammation of the pulp.

Soft tissue on the tooth surface

The appearance of a pink or reddish fabric that is like
grows out of a tooth, a typical manifestation of the hypertrophic type.
The presence of granulations penetrating through carious cavities,
indicates a long course of pathology. Currently,
Such a picture can be met quite rarely, however, with its
detection does not require additional confirmation
diagnosis.

Finding the above symptoms, or a combination thereof, should be
See your dentist soon. He examines the affected
tooth and decide on further tactics.

Treatment

As already mentioned, the pulp performs a very important function –
it nourishes and provides a complete metabolism. Full of her
removal sooner or later will reduce the strength of the tooth and its
gradual destruction. That is why doctors try
use pulpitis treatment methods that do not imply
radical action. Unfortunately, they do not always succeed, because
late treatment of patients.

What are the options for dental interventions? Their
fundamentally divided into two groups:

  1. Conservative – this method implies only the introduction
    drugs to damaged tissues. Its advantage is
    preserving all vessels and nerves, however it can only be used
    in the early stages of the disease. Otherwise, its effectiveness
    will be minimal.
  2. With partial / complete removal of pulp – used when
    detection of nonviable tissue or with its irreversible
    changes.

Determined with the optimal method of treatment of acute pulpitis,
like its chronic form, only dental doctor after
a thorough inspection. With the consent of the patient,
intervention is carried out immediately after the diagnosis of the disease.

Conservative way

This is the best method, with timely treatment of the patient and
no irreversible damage. When using it, a tooth after
treatment of pulpitis retain its full vitality, and not
will suffer from a lack of nutrients. Its principle
The implementation is quite simple.

After local anesthesia, the doctor opens the focus of inflammation and
determines the variant of the disease. If he detects acute
serous form, in most cases it is sufficient to
conservative therapy. To this end, on the inflamed area
superimposed medicinal substances in the form of a paste. It can
be:

  • Antibiotics;
  • Hormones-glucocorticosteroids;
  • Non-hormonal anti-inflammatory drugs;
  • Dentin stimulating medications.

Despite the fact that these drugs have mainly
local action, their particles can penetrate the patient’s blood.
Therefore, before conducting therapy, be sure to warn
dentist about allergy to any pharmacological
substances.

Pulp removal

If during the examination the dentist found obvious signs
damage, he chooses this particular method of elimination of the disease.
In the presence of non-viable soft tissues throughout the tooth,
it is necessary to carry out their complete removal. This kind
Dental surgery is called “devitalization.”

If the inflammatory process did not have time to get to
located deeper part, the preferred method is
�”Vital amputation”. This technique implies an impact
only on the surface areas, while maintaining the main supply
tooth layers. For permanent teeth, this is the option.
is optimal, with the ineffectiveness of the conservative
therapy.

Regardless of how much will be held
intervention, the patient undergoes similar stages of treatment:

  1. Pain relief – most often, doctors block sensitivity from
    whole mandibular nerve. He perceives various sensations not
    only from the teeth, but also from the surrounding organs (gums, cheeks, palate and
    etc.). This allows the operation to be almost painless.
    for the patient;
  2. Opening the affected tooth;
  3. Removing some or all of the affected tissue – usually
    the doctor determines the necessary volume of surgery directly in
    the treatment process;
  4. Placing drugs in the focus of inflammation is a must
    used anti-inflammatory and antimicrobial
    drugs;
  5. Installing a temporary seal.

In the presence of carious cavities, the doctor performs their treatment,
to cleanse and strengthen viable tooth areas.

Treatment у детей

Tooth extraction dentists resort only as an extreme
measures when other methods are ineffective. Are not
exception and younger patients who have not yet
there was an update of the dentition. Until now
common misconception that it is much easier to snatch
pathological focus, what to do with his therapy. However it is not
So.

Treatment молочных зубов должно выполняться по тем же принципам,
as permanent. If they are removed early, the child may
displaced or damaged organ germ. This often leads to
deformations of the entire dentition. If you stick
conservative tactics and allow physiological processes
it is easy to flow on your own
to avoid.

It is also impossible to delay the visit to the dentist’s office – in
In this case, the parents risk the health of their child. With
the absence of adequate treatment often form such formidable
complications like periostitis, osteomyelitis, cellulitis of the face or neck,
meningitis, etc. To prevent them enough in a timely manner
eliminate the infectious focus with the help of a dentist.

What to do after treatment

Often, to rid the patient of the disease is required
repeated visits to the dental office. Average,
adequate therapy requires 2-3 visits to the doctor. AT
in between, it is recommended to follow a number of guidelines in order to
make treatment more effective and prevent development
complications:

  • Eliminate stress on the affected tooth. To save temporary
    fill the next appointment with the doctor and do not receive additional
    tissue damage, should chew on solid food
    Predominantly on the healthy side, avoid dentition
    machine and clean it with care;
  • Withнимать противовоспалительные средства. With наличии
    unpleasant sensations or marked signs of inflammation (edema,
    pain, etc.) you can use non-hormonal medications
    (НПATСами). For example: Meloxicam, Nimesulide (synonym – Nise),
    Ibuprofen;
  • Avoid physical and emotional fatigue. Any
    stress of the body can slow down the recovery process
    the patient, so at the time of therapy, it is better to exclude various kinds
    overload;
  • ATнимательно оценивать свое самочувствие. Appearance of fever,
    strong pain in the face, the formation of subcutaneous formations –
    All this should alert the patient. Having any of
    listed signs is a reason to re-refer to
    to the doctor.
  • Maintain the immune system. It is a full job
    body defenses protects the person from spreading
    inflammatory process and the development of complications. So that the disease does not
    affected their condition, it is enough to start taking multivitamin
    комплексов (Биомакс, ATитрум, Биовиталь и другие).

After therapy, at the last appointment, the dentist will establish
The final seal, which does not require special care. AT ближайшие
2-3 hours after the manipulation should exclude food intake and wait
restore sensitivity on the face. Any other
special events from the patient in the postoperative period are not
required.

Pain в зубе после лечения

Can this symptom occur with adequate
therapy? Yes, in some cases, pain in the tooth after treatment
observed in patients within 1-3 days. Its occurrence is often
associated with periodontal traumatization, the preservation of part of the nerve
endings and a number of other factors. If the intensity is unpleasant
there is little or no sensation, the patient has no fever, and
state of health does not suffer – this is not a cause for concern.

Чтобы снять боли после лечения достаточно использования НПATСов,
such as Meloxicam, Paracetamol, Citramon, Ibuprofen and others
similar drugs. Do not take more than 3-4 tablets per
day, as they can have a negative effect on the wall
stomach.

FAQ

ATопрос: Какие осложнения может вызвать воспаление
pulp?

If the patient has not turned within a few days to a dental
doctor, the inflammatory process may begin to spread beyond
root canal limits. This will lead to the development of periodontitis,
periostitis, osteomyelitis, phlegmon and other complications.

ATопрос: Можно ли вылечить патологию народными
методами therapy?

No, since they have no effect on deep structures.
teeth.

ATопрос: Как проводить стоматологическое лечение,
if you are allergic to pain medication?

AT этом случае, доктор может предварительно обработать
certain sprigs of nerve arsenic paste that help
eliminate most of the discomfort during
interventions.

ATопрос: Как предотвратить возникновение
diseases?

AT большинстве случаев, для этого достаточно правильной гигиены
mouth and regular check-ups in dental
cabinets. Other measures to prevent pathology, unfortunately,
not.

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