Pulpitis: Reversible pulpitis vs Irreversible pulpitis

Question:

“What procedure is done to fix reversible pulpitis”

Answer:

Causes of Tooth Pain

Whether it’s on and off, lingering or thumping, tooth pain is really uncomfortable and sometimes makes it hard to do anything else while the pain persists. Tooth pain causes are outlined in the article. Brushing at least twice a day and flossing daily, along with regular dental visits, are sure ways to prevent tooth decay (cavities). The modified bass technique is an effective brushing technique.

What is Pulpitis?

Pulpitis is an inflammation of the dental pulp. It’s primarily caused by bacteria that enter the pulp. The bacterial infection itself begins with tooth decay. Pulpitis may also be caused by any other type of injury to the pulp. Symptoms of pulpitis range from very mild to very severe. There are two types, and the pulpal diagnosis of each differs based of factors explained below.

What is Reversible Pulpitis?

This means that the tooth inflammation can be reversed, and the tooth symptoms relieved. The tooth therefore has a chance to heal and recover. The inflammation is usually secondary to decay, but may also be due to pulpal injury. Reversible pulpitis symptoms include:

• Tooth discomfort from contact with anything cold or another stimulus.
• Tooth symptoms that are relieved when cold or other stimulus is removed.
• Symptoms that gradually get better.
• Usually the discomfort experienced can be relieved by over the counter pain medications.

Treatment for Reversible Pulpitis

If a tooth has caries (tooth decay) and symptoms of reversible pulpitis, a dentist will remove the decay and replace the lost tooth structure with a dental filling. This reversible pulpitis treatment is usually sufficient to reverse the process. The symptoms normally improve over time, gradually disappearing.

What is Irreversible Pulpitis?

When the pulp tissue (nerve of the tooth) is damaged beyond recovery, this is known as irreversible pulpitis. The pulp will eventually die, and if the tooth isn’t treated soon enough, a tooth abscess (tooth infection) may occur.

A tooth vitality test is often done to confirm a diagnosis of irreversible pulpitis. The usual treatment of irreversible pulpitis is a root canal therapy. This is necessary in order to save the tooth. Irreversible pulpitis symptoms include:

• Spontaneous pain (pain that arises without any provocation). Tooth pain that wakes you up in the middle of the night is usually a sure sign of irreversible pulpitis.
• If the pain is brought on by a stimulus, it usually lingers even after the stimulus is removed.
• The symptoms generally get worse.
• Root canal treatment is usually necessary to treat the problem.

We hope that you found this information helpful!

Pain after Root Canal

Question:

“I just had a root canal treatment in the top tooth, 5th from the middle. It’s been a month since the treatment, and I am having slight pain, it feels slightly loose.  What would you suggest for me to keep my tooth”

Answer:

What is Root Canal Treatment?

A root canal specifically refers to the space inside of the root of a tooth. A tooth may have one or more canals, just as they may have one or more roots.  Root canal treatment (also called root canal therapy or endodontic therapy) involves cleaning out the canal(s), disinfecting the canal(s) and then filling the canal(s).

Why do I need Root Canal Treatment?

Reasons why a root canal treatment may be recommended include:

• Tooth decay that has extended to the pulp
• Exposure of the pulp due to some trauma (this sometimes happens during rigorous sporting activities)
• A tooth that has become infected from decay (known as an abscessed tooth). Sometimes the infection may spread the bone surrounding the tooth.
• Internal resorption

Why does my root canal hurt?

There may be some sensitivity after the procedure, as the tooth heals. Pain after a root canal is not uncommon, though most patients may have no symptoms after treatment. In cases where there is associated pain, some reasons include:

• The associated pain is normal, as the inflammation slowly goes away and the tooth heals.
• There is an extra (much smaller) canal that may still need to be cleaned and filled. Teeth can be weird in this way (extra canals), and even the very best dentist can miss these hidden canals. This is usually corrected by the dentist or endodontist (a dentist who specializes in root canal treatment).
• The pain may actually be originating from the periodontal ligament surrounding the tooth.
• The root canal has failed, and a re-treat or endodontic surgery (also called root canal surgery) may be needed. If there is a dental infection at the root apex (tip), then an apicoectomy (which just means root tip removal) may be necessary.
• The tooth could have been fractures or perforated during the procedure.  Performing a root canal places a lot of pressure on the tooth.  Sometimes, if the tooth is weakened, it may fracture.  This could very well be the cause of your pain and looseness of the tooth.

Remember that each patient’s case is different, so diagnosing and treating depends on individual cases. Please see your dentist as soon as possible for evaluation to determine necessary treatment.

We hope this was helpful to you!

Sensitive and loose teeth

Question:

“Dear Dr, I’m 50 years old and my teeth are very sensitive with looseness, severe pain & falling out due to necrosis. I have big prob to chewing my diet pl advise me”

Answer:

What you are reporting are the sure signs of periodontal disease.  This involves losing the bone around teeth, as well as supporting structures, as a result of bad oral hygiene.

Your question actually sparked us to write a detailed article concerning periodontal disease.  For an in-depth explanation of periodontal disease, please follow the link here: http://www.savemysmile.com/dental-problems/periodontal-disease-dental-problems/periodontal-disease/

Good luck and we hope this helps!

Save My Smile Team

Periodontal Disease

Periodontal Disease

The most common cause of loose and sensitive teeth is periodontal disease. Periodontal disease includes gingivitis (inflammation of the gums) and periodontitis (inflammation of the periodontium). The periodontium is the structure that surrounds the teeth and holds them in their sockets. Periodontal disease is an infection that can cause teeth to become loose and eventually lost.

Periodontal disease is most often caused by bacterial plaque that surrounds teeth. Bacterial plaque is a sticky film that continues to form around teeth. If it isn’t removed constantly, it can continually build up and form calculus (calculus is just a hardened form of bacterial plaque). There are a number of other causes of periodontal disease.

Causes of Periodontal Disease

• Smoking: smoking causes shrinkage of some blood vessels, hence the periodontium is affected by not having enough blood flow and oxygen. Smokers tend to lose teeth more than non-smokers, because of periodontal disease.
• Hormones: gum tissue are sometimes affected by hormonal changes, for example during pregnancy or menopause
• Genetics: some individuals are more prone to periodontal disease, despite proper oral hygiene practices, because of genetic factors. Early diagnosis and treatment may help to save teeth in such individuals.
• Diabetes: diabetics have a higher risk of developing infections, including periodontal disease. Healing is also slower with diabetes, making periodontal disease a greater concern with respect to oral health. Diabetes, though not the only reason, may be a cause of necrosis (tissue death due to lack of blood and oxygen).
• Poor Nutrition: a diet that is low in necessary nutrients affects the body, including the oral cavity. Periodontal disease is a distinct infection that may worsen with poor nutrition.

Treatment of Periodontal Disease

In many cases, an individual may have had long standing or severe periodontal disease, and some teeth (in other cases, all of the teeth) cannot be saved. In these cases, extractions may be the only viable option, with replacement of the missing teeth with implants, bridges or dentures. Other treatment options are available for treating periodontal disease, each option depending on individual cases/.

• Scaling and root planning: this involves professional cleaning of plaque and calculus from root surfaces and periodontal pockets. This is the most common method used to treat periodontal disease.
• Periodontal surgery: if the tissues around the teeth are determined to be unhealthy, periodontal surgery (there are more than one types) may be necessary to treat the periodontal disease. Periodontal surgery can help to improve function.
• Cosmetic methods: this can be done to improve a patient’s appearance, smile and function, if for example a lot of roots are exposed by the periodontal disease.

Each individual’s case of periodontal disease is different, so the necessary treatment may be different for each patient. An individual with a diagnosis of periodontal disease, especially long standing or advanced, can be treated by a periodontist (a dentist with specialized training in diagnosing, preventing and treating periodontal disease). You can be referred to a periodontist by a general dentist, or be treated by a general dentist. Please be pro-active in a consulting with your dentist for a comprehensive evaluation, diagnosis and treatment.

We hope this helps!

Signs of Gingivitis

Gum disease, known as gingivitis (or it’s more severe form, periodontitis), refers to the inflammation of the gums (gingiva).  It results from accumulation of bacteria near the gum line, causing bacterial invasion into the tissues of the body.  If not addressed and treated, gingivitis will lead to recession of the gums, bone loss, tooth loss, and systemic disease.

Signs of Gingivitis

• Swollen gums
• Bleeding gums (especially when brushing or flossing)
• Shiny or red gums
• Associated pain
• Bad breath or foul smelling gums
• Gum recession (teeth appear longer)

Causes of Gingivitis

• Most often caused by plaque accumulation and poor oral hygiene habits
• Hormonal changes (i.e. pregnancy)
• Certain medications that may suppress the immune system

Gingivitis is a mild form of inflammation.  Unlike it’s more serious form, periodontitis, gingivitis can be treated quickly and easily if addressed in a timely fashion.

Treatment for Gingivitis

• Improve oral hygiene habits – Brush after each meal and floss every day.  If this regimen is followed precisely, the bleeding will eventually stop.
• Incorporate a mouth rinse, preferably with chlorohexidine, into your daily routine.  This can assist with the removal of unwanted bacteria.
• Visit the dentist and get a cleaning – The dentist will be able to effectively remove plaque and calculus, the main causes of gingivitis.  However, it’s up to you to maintain the plaque free mouth after this point.
• Antibiotics – If serious, the dentist may prescribe antibiotics to control the bacterial invasion.

All in all, gingivitis can easily be managed if addressed early.  Take the right steps in keeping up with your oral hygiene to maintain a healthy smile.

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