PulpitisPulpitis is medical symptom in which the dental pulp becomes inflamed.

• Once the pulp has become inflamed, the tooth can be diagnostically divided into two categories:

• Reversible Pulpitis• Irreversible Pulpitis

Irreversible Pulpitis

• This is the condition where the pulp is irreversibly damaged. The pulp can not recover from the insult and damage. For example, decay that has reached the pulp of the tooth introduces bacteria into the pulp. The pulp is still alive, but the introduction of bacteria into the pulp will not allow the pulp to heal and it will ultimately result in necrosis, or death, of the pulp tissue.

Appearance

Causes:

• 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.

Management:

• The pulp of a tooth with irreversible pulpitis may not be left alone to heal. The tooth may be endodontically treated whereby the pulp is removed and replaced by gutta percha. An alternative is extraction of the tooth. This may be required if there is insufficient coronal tissue remaining for restoration once the root canal therapy has been completed.

• Root canal or tooth extraction.• Do not delay management more than a few days.

Reversible Pulpitis

• This is the condition where the pulp is inflamed and is actively responding to an irritant. This may include a carious lesion that has not reached the pulp.

• Symptoms include transient pain or sensitivity resulting from many stimuli, notably hot, cold, sweet, water and touch. The pulp is still considered to be vital. This means that once the irritant is eliminated, usually by removal of decay and the placement of a filling, that the pulp will return to its normal, healthy state.

Apperance

Causes:

• Cavities that haven't reached the nerve yet.• Erosion of the tooth that reaches the dentin• Drilling done by a dentist when doing a filling

or crown preparation on the tooth• A fracture of the enamel layer of the

tooth which can expose the dentin• Getting your teeth cleaned (scraped!) by a

dental hygienist, especially when they clean the roots if you have periodontal disease.

Management:

• Dental Caries debris removed• Dental filling applied