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Why is pulpitis a dental emergency?

Todd A. Welch, DMD
Periodontics
Irreversible pulpitis is a severe inflammation of the dental pulp. Irreversible pulpitis is often occurs after reversible pulpitis when the cause of the pulpitis has not been removed. So, irreversible pulpitis can be caused by everything that causes reversible pulpitis and the following:
  • When a dentist needs to remove lots of dentin due to big cavities and gets really close to the pulp.
  • When the blood flow to the pulp gets decreased or removed. This could be caused by orthodontic treatment, such as braces, that makes the tooth move so fast that the blood vessels can't keep up and the pulp's blood supply gets cut off. It could also be caused by trauma that severs the blood vessels and slowly kills the pulp.
  • Very deep cavities that go through the enamel and all the way through the enamel right into the pulp. The bacteria then cause inflammation in the pulp. The more the body tries to fight off the bacteria, the higher the pressure gets inside the tooth until the pressure may strangle the blood vessels and cause the pulp to die.
The symptoms of irreversible pulpitis can range from no symptoms at all to an excruciating spontaneous pain. The tooth can be very sensitive to the slightest temperature change, such as breathing in room-temperature air. The pain usually lingers as well. For example, if you're eating ice cream and the pain stays for longer than five to ten seconds after you've swallowed the ice cream, it could be a sign of irreversible pulpitis.

If you start to feel pain, it is best to get in touch with your dentist. A small amount of pain (like that seen in reversible pulpitis) is normal following a filling or deep cleaning. If the pain persists, you may want to meet with your dentist to try to figure out the cause of the pain before your pulpitis progresses to irreversible pulpitis and you have to have a root canal treatment or get the tooth extracted.
Pulpitis is inflammation or infection of the pulp (nerve), which is the center of the tooth. This is different from an abscess. You may experience pain  eating hot, cold, or sweet foods. Many toothaches like this can be fixed with a filling. However, some are irreversible and require root canal treatment, which involves the cleaning out of the pulp contents (blood vessels and nerves), or extraction of the tooth.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.