Pulpitis is the inflammation of the center pulp chamber and canals in a tooth. If a tooth has inflammation in its center, called the pulp chamber, the nerve in that chamber becomes more easily excitable or “stimulated.” Therefore, it takes less stimulus to set off a pain signal, which means a normal amount of cold causes the tooth’s nerve to become painful. On top of that, the cold constricts the tooth, increases the inflammatory pressure in the tooth, and sets off a more intense pain response. The question here is “what” and “if” something is causing pulpitis?
If tooth pulp has inflammation or pulpitis, it can be further divided into “possibly reversible pulpitis” or “irreversible pulpitis.” Teeth are pretty bad at healing themselves, unlike most other body parts. However, they can sometimes heal independently, depending on the amount of inflammation. What happens is the tooth pulp will recognize some sort of insult to the tooth. For example, let’s say you bumped a tooth hard. The tooth pulp will then become inflamed to repair the damaged tissue itself. However, in other cases, it will not repair itself. Instead, the inflammation will increase until the tooth pulp eventually gives out, dies, and becomes infected due to the lack of blood supply. Ultimately this will cause more pain once the infection has progressed far enough.
Irreversible Pulpitis is when inflammation in your tooth has reached the point that the tooth will never fully heal.
There are tests to determine which route the inflammation may go to diagnose the type of pulpitis, either reversible or irreversible. You may use a pulp tester or, once again, use the cold test. Unlike dentin hypersensitivity, if the cold test sensitivity lasts longer than 10 seconds
, it is likely irreversible pulpitis. A tooth with Irreversible pulpitis will never fully heal at this stage, regardless of the pain level you are experiencing. The only way to permanently treat irreversible pulpitis and save the tooth is to have a root canal treatment done, and the sooner, the better. The longer the infection festers, the more likely the chances of a root canal failure. And again, for those afraid of the thought of a root canal, once you are numb, a root canal is just a boring appointment and shouldn’t be bad at all.
Reversible Pulpitis is when inflammation in your tooth can possibly settle and heal.
If a cold test sensitivity lasts less than 10 seconds
and longer than 3 to 4 seconds, it is possibly reversible pulpitis. I call it “possibly reversible” because reversible pulpitis always has the possibility to progress into irreversible pulpitis, which ultimately means the tooth needs a root canal treatment or extraction to fix it. Luckily, I have found an excellent technique for my patients to minimize the chances of reversible pulpitis progressing into irreversible pulpitis. I have even used this technique on myself.
If pulpitis has become irreversible there is no simple remedy. The tooth will need dental treatment to correct pulpitis. If pulpitis is still possible reversible the remedy is to take Ibuprofen to reduce the inflammation.
I tell my patients to take 400mg Ibuprofen, or whatever the label tells you to on the over-the-counter bottle, three times a day for three to four days. Ibuprofen, in this case, isn’t for the pain, though it helps with that too. Ibuprofen is an anti-inflammatory and can reduce inflammation just enough so that your tooth can optimally heal itself. If Ibuprofen is hard on your stomach, you have two options to run by your doctor. He could also prescribe a steroidal anti-inflammatory, like Medrol, in its place, or you can take omeprazole before taking ibuprofen. Omeprazole can calm the stomach before taking Ibuprofen. Omeprazole is an over-the-counter drug, and its brand name is Prilosec OTC.