Pulpitis Treatment: Saving Your Tooth From Pain and Loss

Pulpitis is the medical term for inflammation of the dental pulp (pulp). The dental pulp is the soft tissue inside the tooth that contains blood vessels, nerves, and connective tissue. It is vital for the development of the tooth and its perception of stimuli. If it becomes irritated or infected, inflammation occurs – pulpitis.

The most common causes of pulpitis are:

• Deep tooth decay: Bacteria from decay penetrate the enamel and dentin to the dental pulp, where they trigger an inflammatory reaction. This is by far the most common reason.
• Tooth trauma: A strong impact can damage the blood vessels supplying the pulp or cause a crack in the tooth that bacteria can penetrate.
• Repeated dental procedures: Multiple fillings or preparations on one tooth can irritate the pulp.
• Cracks in the tooth: Even microscopic cracks can allow bacteria to access the pulp.
• Thermal or chemical irritation: For example, when teeth are bleached improperly or when grinding on a crown without sufficient cooling.
• Periodontitis: Advanced gum inflammation can sometimes lead to infection of the pulp through the root system.

We distinguish two basic types pulpitis:

1. Reversible pulpitis: This is a mild inflammation where the pulp is irritated but still capable of regeneration if the cause is removed (e.g. incipient caries). The pain is usually short-lived and triggered by a specific stimulus (cold, sweet).
2. Irreversible pulpitis: The inflammation is so advanced that the pulp is unable to heal itself. Bacteria have infected the tissue and without treatment the inflammation progresses, the pulp dies (necrotizes) and the infection can spread further into the bone around the root of the tooth (so-called periodontitis, a pocket develops). The pain is typically spontaneous, strong, throbbing and long-lasting.

Symptoms vary depending on the type and stage of pulpitis. It is important to pay attention to any changes in tooth sensitivity or pain.

Symptoms of reversible pulpitis:

• Sharp but short-lived pain or increased sensitivity to cold or sweet stimuli.
• The pain quickly subsides after the stimulus is removed.
• The pain is not spontaneous (it does not occur on its own).

Even these milder symptoms should prompt you to see a dentist. Early treatment of the cause (e.g., by removing the decay) can prevent the development of more serious, irreversible pulpitis.

Symptoms of irreversible pulpitis:

• Spontaneous pain: The pain occurs without an obvious stimulus, often suddenly.
• Severe, throbbing pain: The pain is often very intense, throbbing.
• Prolonged pain: The pain persists even after the stimulus (if any) has been removed, and can last minutes to hours.
• Night pain: The pain often worsens at night, when lying down, and wakes the patient from sleep.
• Pain on heat: Unlike reversible pulpitis, here the pain is often triggered or worsened by a warm stimulus (e.g., a hot drink). Cold can sometimes provide temporary relief.
• Pain when biting: If the inflammation progresses to the tip of the root, the tooth may be sensitive to tapping or biting.
• Shooting pain: The pain may shoot into the surrounding teeth, jaw, ear, or temple.
• Sometimes, paradoxically, the pain may stop for a while if the pulp dies completely. However, this does not mean that the problem has disappeared – the infection can silently spread further.

With these symptoms, a visit to the dentist is absolutely necessary and urgent! Postponing treatment leads to the spread of the infection, the risk of developing an abscess (a sac with pus), swelling, and in extreme cases, tooth loss or general health complications.

A correct diagnosis is the key to successful treatment. At Dobrý Dent, we approach diagnostics comprehensively and use modern procedures and technologies to accurately determine the condition of your tooth.

The diagnostic process usually includes:

• Anamnesis: We will ask you in detail about the nature of the pain (when it started, what it is, what causes/exacerbates it, how long it lasts), previous dental treatment, and your overall health.
• Clinical examination: We will carefully examine the affected tooth and surrounding tissues, looking for signs of decay, cracks, swelling, or a fistula (a small canal through which pus can escape).
• Vitality (sensitivity) tests:
  • Cold test: We apply a cold stimulus to the tooth (e.g. a cotton ball soaked in a special spray). The reaction will help us distinguish between a healthy tooth, reversible and irreversible pulpitis or dead pulp. In irreversible pulpitis, the reaction is often exaggerated and the pain persists even after the stimulus is removed. In a dead tooth, the tooth does not react at all.
  • Electrical Pulp Test (EPT): Measures the reaction of nerve fibers in the pulp to a weak electric current.
• Percussion Test: By gently tapping the tooth, we determine whether there is sensitivity, which may indicate the spread of inflammation to the area around the root (periodontitis).
• Imaging Methods:
  • Intraoral X-ray (X-ray): A basic and necessary examination that shows us the extent of the caries, the condition of the roots, any changes in the bone around the root tip (vesicles) and the quality of previous treatments.
  • 3D CBCT (Cone Beam Computed Tomography): In our Dobrý Dent clinic, we have this advanced 3D X-ray. We use it in more complex cases – for example, when a conventional X-ray is unclear, in teeth with complicated root canal anatomy, when a root fracture is suspected, or before repeated endodontic treatment (re-endodontics). CBCT provides a detailed three-dimensional image of the tooth and surrounding structures, which allows us to diagnose the problem with absolute accuracy and plan the best possible treatment.

Thanks to the combination of these methods and our many years of experience (since 2010), we are able to make an accurate diagnosis and design an optimal treatment plan tailored to your specific situation.

Treatment of pulpitis depends on its type (reversible vs. irreversible) and the extent of tooth damage.

Treatment of reversible pulpitis

If reversible pulpitis is diagnosed, treatment is aimed at eliminating the cause of the irritation. The most common treatments include:

• Removing tooth decay and making a high-quality filling: We thoroughly remove the decayed tissue and hermetically seal the tooth with a filling (amalgam, composite).
• Adjusting or replacing a non-compliant filling/crown.

The goal is to soothe the irritated pulp and allow it to regenerate. Once the cause is removed, the pain and sensitivity should gradually subside.

Treatment of pulpitis, especially endodontic treatment, requires experience, precision and quality equipment. The Dobrý Dent Clinic offers you:

• Experienced and professional team: Our doctors have extensive experience in diagnosing and treating pulpitis and regularly receive training in the field of endodontics. We have been operating in Prague 5 since 2010.
• High-tech for maximum success:
  • Operating microscope: Essential for precise and thorough treatment of root canals. Increases the chance of saving the tooth.
  • STA system: For the most comfortable and painless application of anesthesia.
  • 3D CBCT X-ray: For detailed diagnostics in complex cases and precise treatment planning.
  • 3D intraoral scanner: For precise and comfortable fabrication of crowns and onlays after endodontic treatment.
  • Modern rotary endodontic instruments and apex locator: For effective and safe canal treatment.
• Emphasis on painlessness: We understand that fear of pain is a common barrier. That is why we place great emphasis on effective anesthesia and gentle procedures.
• Individual approach: Every patient and every tooth is unique. We will propose a treatment plan tailored to your needs and possibilities.
• Comprehensive care under one roof: We offer a wide range of dental services, from prevention and dental hygiene, through conservative dentistry, endodontics, prosthetics to implantology. You can solve everything conveniently in one place.
• Modern and pleasant environment: Our clinic in Anděl (Prague 5 – Smíchov) is designed to make you feel as comfortable and safe as possible.
• Transparency: Before starting treatment, we will always discuss the proposed procedure with you in detail, its benefits, risks and financial requirements.

Of course, the best treatment is prevention. In most cases, pulpitis can be prevented by following a few principles:

• Perfect oral hygiene: Regular and proper tooth brushing (at least twice a day) and using interdental brushes or dental floss to clean the spaces between the teeth, where caries often occur.
• Regular preventive examinations: Visit your dentist at Dobrý Dent at least twice a year. A preventive examination will allow you to detect incipient tooth decay or other problems that could lead to pulpitis in time.
• Professional dental hygiene: Have regular (usually 1-2 times a year) dental hygiene. The hygienist will remove tartar and plaque from places you can’t reach yourself and advise you on the correct cleaning technique.
• Early treatment of tooth decay: Don’t let even a small cavity go unnoticed. The sooner the cavity is treated, the lower the risk of affecting the dental pulp.
• Protecting teeth during sports: Use a mouth guard when playing contact or risky sports.
• Balanced diet: Limit consumption of sugary and acidic drinks and foods that contribute to tooth decay.

Pulpitis is a serious condition that can lead not only to tooth loss, but also to other health complications. If you experience any toothache, especially severe, spontaneous or long-lasting, do not hesitate to contact us as soon as possible. Early diagnosis and professional treatment at the Dobrý Dent clinic can save you a lot of pain and save your tooth.

Our team is ready to provide you with the best care using modern technologies and an individual approach. Your health and comfort are our priority.