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!

I have tooth pain

Question:

Hi, I have been experiencing some weird tooth pain.  It comes as quickly as it goes and does not seem to last long( a few seconds) and has happened three times in the last 2 days.  It is not a throb pain, more a constant pain if that makes sense.  It feels like someone is touching ice cream to my tooth in the whole tooth but 10x worse, and is one of the worst pains I have ever experienced.  I am going to the dentist, I am just curious on your opinions.  Had a cavity filled in the tooth a couple months ago so not too sure why it would hurt all a sudden.  Thanks in advance.

Answer:

Thanks for submitting your question with us.  Now, the main piece of information that will determine the diagnosis of your tooth is:

Is the Pain provoked?

• Does the pain have a trigger point?  For instance, is it painful when you eat hot or cold food or drinks.
• Does the pain occur sporadically and unprovoked?  Does the pain come and goes as it pleases with no trigger point?  For example, the tooth becomes painful randomly throughout the day.
• Does the pain come when you bite down into food?  Or does the pain come when you open your mouth after biting down on food?

You’re probably wondering, why all the questions?  But believe it or not, answers to these simple questions can guide us down the right path to a correct diagnosis.  Let’s examine each answer:

Yes, the pain is provoked by eating cold/hot food or drink.

Then you have reversible pulpitis.  This means that you have slight inflammation of your pulp inside of your tooth.  This is caused by

• Bacteria/decay
• A recent deep filling without a protective base (Deep restorations need a protective layer underneath it to protect the tooth nerve/pulp)
• Recent deep cleaning

Reversible Pulpitis Treatment

Luckily, this can be easily treated by making a slight adjustment to the filling

No, the pain is not provoked by anything and occurs on its own

You may have irreversible pulpitis.  This means the pulp is damaged beyond repair.  This means that bacteria have leaked into your tooth nerve/pulp and are now irritating the tooth and needs to be removed to avoid serious infection.  Some signs of irreversible pulpitis include:

• Spontaneous, unprovoked pain
• On and off pain
• Continuous pain
• Pain lasts even after food/drink/or stimulus is removed
• Lying down or bending over produces pain

Irreversible Pulpitis Treatment

The treatment for irreversible pulpitis is a root canal treatment.

I feel pain when I bite down

Again, this indicates reversible pulpitis and can be treated by adjusting your filling.

I have pain when I open up after biting down

This indicates a fracture of the tooth.

Fractured Tooth Treatment

Treatment for this depends upon the extent of the fracture and can include anything from a new filling, or a root canal, or even an extraction.

For more information on tooth pain, check out our article here.

Also, see below for a descriptive chart of how to diagnose tooth pain.

We hope this helps and good luck,

Save My Smile Team

My tooth hurts when I eat hot or cold food or drinks

Question:

My tooth hurts whenever I eat hot or cold food or drinks.  If feels like a sharp pain, then it goes away.  What does this mean?

Answer:

This is a sure sign of reversible pulpitis.  The feeling that you are experiencing is caused by exposed dentin.  Remember that dentin is normally covered by enamel (see article on tooth anatomy), if for some reason a portion of dentin is left uncovered, you will usually feel sensations of short, sharp pain when exposed to hot or cold substances.  Exposed dentin can be caused by a cavity, a defective filling/restoration, or recent dental work.  The good news is that this problem can be fixed easily, the dentin just needs to be covered.  Your dentist will be able to give you a filling, simply fix your existing filling, or a pulp cap if necessary.  However, don’t wait too long.  Reversible pulpitis, if left untreated, can turn into irreversible pulpitis.  Unfortunately, irreversible pulpitis can only be treated with root canal therapy, which costs a lot more in the end.  So be sure to act now by visiting your dentist.

Good luck!