Adults

Pulpitis: Types, Symptoms, & Treatment

This blog has been reviewed and approved by Dr. Stephanie Gans.

Within each of your teeth lies a substance known as pulp, which contains connective tissue, nerves, and blood vessels. Pulpitis is a condition causing inflammation of this dental pulp, typically due to bacterial infection or irritation. Pulpitis initially presents as minor inflammation, which, if its cause is addressed, can be reversed by your dentist. If left untreated, the condition can progress to severe damage of the tooth’s pulp. At that point, treatment such as a root canal or, in some cases, tooth extraction may be necessary. Advanced infection can also spread beyond the tooth, potentially affecting the surrounding jaw and facial areas.
In this article, we will examine the frequent triggers of pulpitis, its various symptoms, and how dental professionals diagnose and manage the condition.

KEY TAKEAWAYS

TABLE OF CONTENTS

What is Pulpitis?

Your teeth consist of three distinct layers:

Enamel: the robust, protective outermost layer.
Dentin: the softer middle section.
Pulp: the innermost layer, housing nerves, connective tissues, and blood vessels. As its name implies, pulpitis affects your tooth pulp, causing it to become inflamed, painful, and more susceptible to temperature changes. Pulpitis often arises from cracks and cavities in teeth, which permit bacteria to infiltrate, or when irritation occurs within a tooth due to grinding.

Types of Pulpitis

Pulpitis is categorized according to the degree to which the infection has progressed. The classifications of pulpitis include:

Reversible Pulpitis: In its initial phases, pulpitis manifests as milder inflammation and pain. Any damage to the tooth pulp is reversible, and a dentist can fully eliminate the source of irritation by repairing and sealing the tooth.
Irreversible Pulpitis: If left unaddressed, the inflammation and damage caused by pulpitis will result in the death of the tooth pulp. In such scenarios, a root canal or complete tooth extraction might become necessary.

Pulpitis Symptoms

You might experience a range of pulpitis symptoms, depending on the advancement of your case, but the primary impact of the condition is pain. Both forms of pulpitis may also induce a more pronounced sensitivity to hot and cold foods.

Symptoms of reversible pulpitis include:

Tenderness and toothache.
Brief, sharp pains upon contact with hot and cold food. Symptoms of irreversible pulpitis include:
Prolonged, throbbing pain when encountering hot and cold food.
Halitosis (bad breath) and an unpleasant taste in the mouth.
Fever may occur if a dental infection spreads beyond the tooth.
Pain when the affected tooth is touched.
Swelling around the gums.

When pulpitis progresses to an advanced stage, the pulp inside the tooth can become severely damaged and lose its vitality. This condition is known as pulp necrosis. Symptoms may change at this point, as temperature sensitivity often diminishes, while pain may persist at a more constant or dull level.

Causes of Pulpitis

Under normal conditions, enamel and dentin protect the tooth pulp by forming strong, intact barriers that block bacteria. When these layers are weakened or broken down by decay, cracks, or trauma, the pulp can become exposed. This allows bacteria to enter the inner tooth and trigger inflammation, leading to pulpitis.

Common reasons for the tooth pulp becoming exposed include:

Oral trauma resulting in injury and fractures to a tooth.
Repetitive trauma, such as that caused by teeth grinding (bruxism) or malocclusion (jaw misalignment).
Progressive decay or a dental cavity.
A fractured or dislodged filling, or a dental restoration that no longer provides a proper seal.

Certain lifestyle choices can elevate your risk of pulpitis by increasing the likelihood of exposed pulp. These include:

Neglecting proper oral hygiene.
Regularly participating in sports or activities that carry a high risk of mouth trauma, e.g., boxing.
A poor diet rich in sugars and acids.

Illustration of cross section of a tooth

Diagnosing Pulpitis

If you suspect you may have pulpitis, a visit to your dentist is imperative. Initially, a dentist will utilize an X-ray to examine the tooth's internal structure, pinpoint the extent of decay, and look for alterations in the bone encircling the root that could signal an infection. To assess the degree of damage to your tooth pulp, your dentist may conduct a sensitivity test. These evaluations include:

Electric Tooth Pulp Tests: A small electrical stimulus is applied to the tooth to assess whether the pulp’s nerves respond. A response can suggest the pulp is still responsive, but results aren’t definitive on their own and must be interpreted alongside other tests and findings
Temperature Tests: A hot or cold probe is applied to the tooth. If you react sensitively to the temperature shift, the pulp is active; if not, this may suggest may suggest loss of sensibility
Tooth Tap Tests: A small instrument is used to tap your tooth. Pain upon this action frequently suggests that the inflammation has spread to the surrounding tissues, indicating irreversible pulpitis or pulp necrosis.

Pulpitis Treatment

Once diagnosed, the pulpitis treatment recommended by your dentist will depend on the severity of your infection. For minor and reversible pulpitis, treatment will focus on eliminating the source of inflammation and reducing the potential for reinfection. This usually involves removing decayed sections of the tooth and subsequently resealing them to prevent future bacterial penetration. Irreversible pulpitis demands more significant intervention, potentially involving a specialist. The two most common treatment choices for irreversible pulpitis are:

Root Canal Treatment: A root canal is a procedure designed to remove infected tooth pulp. It is performed by a dentist or an endodontist (a specialist dentist) who accesses the tooth, extracts the infected pulp, thoroughly cleanses and disinfects the inner chamber of the tooth, then fills and seals the root canal space. Afterward, the tooth is often restored with a filling or crown to prevent reinfection and provide structural support. A successful root canal saves the tooth from extraction and wards off future infection.
Tooth Removal: In certain instances of irreversible pulpitis and pulp necrosis, preserving your tooth may not be possible. In such cases, a tooth removal (extraction) will be performed to prevent the infection from spreading into the jawbone and adjacent tissues.

Pulpitis Complications

If pulpitis remains unaddressed, it can lead to serious complications. Irreversible pulpitis can result in infection and painful abscesses at the tooth's root, known as periapical abscesses. An infection in the tooth root is potentially hazardous and can disseminate into the jaw, neck, chest, and even the brain if not treated promptly. Indicators of an infection include pain around the tooth root and the site of infection, a fever, and swollen glands. If you experience these symptoms, consult your doctor as quickly as possible.

Female patient being examined at dental clinic

Pulpitis Prevention

Pulpitis is a serious condition, and while you cannot completely eliminate your chances of developing it, you can adopt several lifestyle changes to minimize your risk. The most effective way to prevent pulpitis is through diligent oral care. Brushing your teeth twice daily and flossing regularly will keep your teeth clean and help decrease bacterial accumulation. Routine dental visits are also advised to check for cavities, tooth decay, and other risk factors for pulpitis. Additionally, you should use a mouthguard if you grind your teeth at night or participate in any activities with a high potential for oral trauma. If you suspect a cracked tooth or any breach in your enamel, visit your dentist as soon as possible to restore the tooth's integrity.

Crest and Oral-B Know That Healthy Gums Are the Foundation of a Healthy Mouth

Healthy gums are essential for strong teeth and overall mouth health. If you develop gum disease (gingivitis or periodontitis), the first step is to see a dental professional who can assess the level of periodontal disease and recommend treatments like scaling and root planing. In addition, you can support your gums at home with the right products:

Crest Gum Detoxify is a stannous fluoride toothpaste whose activated foam helps neutralize harmful plaque bacteria—even in hard-to-reach areas—when used as part of your daily routine. It is clinically proven to promote healthier gums.
Crest Pro-Health Complete Clean Mouthwash  is clinically proven to provide 24-hour protection against plaque and gingivitis when used twice daily.
Oral-B iO electric toothbrushes help protect against tooth and gum problems. For existing gum issues, they have been shown to be more effective than a manual toothbrush and certain sonic toothbrushes. When paired with the brush tracking app, the Oral-B iO can help you manage even advanced gum concerns more effectively.
Oral-B iO Gentle Care replacement brush head features more than 4,000 thin, high-density bristles that adapt to tooth contours for a gentle yet effective clean. Used with the iO toothbrush, it delivers superior cleaning along the gumline compared with a regular manual brush.
Oral-B Glide Pro-Health Deep Clean Floss uses microtextured fiber to remove plaque and help prevent gingivitis as part of a comprehensive dental care plan.