What is pulpitis and how to treat it?

Why is the dentist tinkering with a needle in my teeth, and what is happening?

People often put off a visit to the dentist. First, there is a small cavity in the tooth, but the patient calms himself: "I'll go later, when in the mood."  When the small cavity is transformed into a large one, and it causes the patient constant discomfort, such as pain when taking acidic, sweet or cold food. History repeats itself: the patient suffers, but does not go to the doctor. The waiting results in a logical end - a thorough and severe pain.

When an unbearable toothache happens - even painkillers do not help. Pain appears spontaneously and spreads to other parts of the face. It becomes unbearable to chew, sleep, and even when the tongue touches the tooth it is sore. Swelling may appear.

When the patient makes a visit to the dentist at last, the doctor makes a diagnosis: acute, chronic or exacerbation of chronic pulpitis or periodontitis.

What to do if you have been diagnosed with pulpitis or periodontitis?

Patients often ask the dentist to remove the tooth in order to get rid of the pain. Remember, the task of a good dentist is to save the tooth. Therefore the indications for tooth extraction can be given only if the tooth is damaged to such an extent that it cannot be repaired. If the tooth can be restored by doing a filling, repair or prosthesis - it is worth preserving.

Why are endo instruments (needles) needed during treatment?

Many patients believe that the task of the dentist is to remove the nerves and to do fillings. In general, they are right. However, before doing a filing, a series of preparatory work needs to take place.

The following are some stages in root canal treatment:

  1. The first and most important is the diagnosis stage.
  2. Determination of methods of treatment (under anesthesia or by immobilization of the nerve by arsenic or other drugs)
  3. Gaining access to the pulp (nerve).
  4. Cleaning the pulp with special tools, including the crown and root parts.
  5. Treatment of root canal by mechanical methods and medications.
  6. Filling the root canal
  7. Restoring the crown.

Let us consider points 3-7.

Gaining access to the pulp (nerve)

This is the stage of drilling the cavity and widening the pulp without leaving any overhanging edges.

Cleaning the pulp with special tools, including the crown and root parts.

Removal of the nerve pulp is usually painless. If pain does occur the dentist needs to administer another injection. Sometimes because of thin or curved canals, the removal of the nerve requires a longer time than usual.

Treatment of root canal by mechanical methods and medications

This stage is one of the most important. At this stage needles of various diameters for different functions are used. At this stage, the root canal is aligned and smoothed and the remains of "the broken nerve." is removed. This stage is demanding for both patient and dentist The dentist must perform expansion of the canal and use medication, while the patient is required to keep his/her mouth open. An X-ray can be taken at this stage in order to ensure that the canal passage is correct.

Filling the root canal

The root canal is filled with a special filling material. The entire length of the root canal must be sealed tightly, otherwise, complications may occur. There are cases when the filling material can be used up to the top of the canal or go beyond it - this depends on the clinical case and on the treatment method chosen. At present one of the best filling methods uses "Thermophiles". However, because of the high cost to the patient, this method is not in demand. The most common method of lateral condensation with gutta-percha and sealers is much cheaper and simpler to use.

Restoring the crown

It is not necessary to do the filling or restoration work of the canal immediately after treatment. This can be done at the next visit to the dentist. This is because the canal filling may produce complications in the form of shrinkage or allergic reactions in the periodontal tissues.

Dr. R Kozhman recommends the following:

  1. If a cavity appears in your tooth make sure to see a dentist as soon as possible. This will simplify treatment and would reduce the cost.
  2. It is advisable that a control x-ray is taken following canal filling to ensure proper treatment has been administered.
  3. X-ray is the only way to ensure the correctness of the operation. Therefore, If the dentist asks to take more images it is advisable not to refuse.
  4. Pain after root-canal filling is to be expected. Pain when biting is normal up to 2 weeks after treatment.  However, if the pain becomes severe you are advised to see a dentist.