Pulpitis

What Exactly Is Pulpitis?

When bacteria from deep decay or trauma reach the pulp, the body responds with inflammation. Because the pulp is “trapped” inside the hard tooth, this inflammation presses on the nerves and causes the characteristic intense pain.

Types of Pulpitis

1) Reversible Pulpitis

Mild inflammation that can be reversed if the cause is removed. Usually accompanied by:
Brief sensitivity to cold or sweet (lasting seconds)
No spontaneous pain
Discomfort resolves when the stimulus is removed
Treatment: conservative (decay removal, deep filling) — the tooth often recovers without root canal treatment.

2) Irreversible Pulpitis (Acute)

Severe inflammation that cannot be reversed — requires root canal treatment. Symptoms:
Intense, persistent, throbbing pain
Spontaneous pain, often at night when lying down
Persistent sensitivity to cold/heat lasting for minutes
Difficulty pinpointing which tooth hurts (referred pain)
Pain that worsens with heat and is temporarily relieved by cold

3) Chronic Pulpitis

Persistent, milder inflammation without acute symptoms. Often “silent”, discovered during a preventive check or on X-ray. It also requires root canal treatment.

4) Pulp Necrosis

Final stage: the pulp has “died”. Paradoxically, the pain may stop — but the infection continues and can lead to a periapical abscess. An important sign: dark/grey discolouration of the tooth.

Knocked-Out Permanent Tooth (Avulsed Tooth)

This is the most time-critical paediatric dental emergency. A knocked-out permanent tooth can often be saved — but only if it’s reimplanted within 30–60 minutes.

How We Diagnose Pulpitis

Detailed history taking (when it started, character of pain)
Clinical examination — checking for visible decay, cracks
Sensitivity tests with cold/heat
Bite test (response to pressure)
Digital X-ray (periapical) for precise assessment of the damage

Treating Pulpitis

Reversible pulpitis:

Decay removal, deep filling with biocompatible pulp protection material. Re-evaluation in 1–3months.

Irreversible pulpitis or necrosis:

Root canal treatment in 1–2 appointments: removal of the affected pulp, cleaning and disinfection of root canals, sealing with bioceramic material. Then — usually — placement of a crown.

How to Manage Pain Until Your Appointment

Take a common painkiller (paracetamol or ibuprofen)
Avoid hot drinks/food — they worsen the inflammation
Try a cold compress on the outside of the face
Sleep with your head elevated — reduces pressure on the pulp
DO NOT place aspirin directly on the tooth — it causes gum burns
DO NOT delay your dental visit

Everything You Need to Know

Frequently Asked Questions (FAQ)

How do I distinguish pulpitis from ordinary sensitivity?

Ordinary sensitivity is caused by exposed dentin and lasts only seconds after the stimulus. With pulpitis, the pain lasts minutes after the stimulus — and there’s often spontaneous pain without stimulus, especially at night.

Can pulpitis go away on its own?

Only reversible pulpitis can — and only if the cause is removed (usually decay). Irreversible pulpitis DOES NOT resolve on its own; it progresses to pulp necrosis and a periapical abscess.

Why is the pain worse at night?

When you lie down, blood flow to the head increases — and therefore also to the inflamed pulp —increasing pressure and pain. Sleeping with your head elevated helps.

How quickly do I need to see a dentist?

If you have intense, spontaneous pain: within 24–48 hours. Delay can convert reversible pulpitis into irreversible — requiring root canal treatment instead of a simple filling.

Can I save the tooth from a root canal?

Most adults with healthy gums and adequate bone are suitable. Diabetic patients, those with osteoporosis or smokers require careful evaluation. Patients with significant bone loss can usually still receive implants — with bone grafting or a sinus lift. At Dentistar, the initial assessment determines if and how we can proceed.

How long does treatment take?

Cost depends on the number of implants, the type of restoration, whether bone grafting is needed and whether guided technique is applied. At Dentistar, you receive a clear and transparent quote after digital planning.