Every person in the world is faced with toothache , various factors can provoke it. If you do not seek qualified help in time, the consequences of inaction can lead to serious problems, which most often result in tooth extraction. Very often, dentists, examining the next patient, find pulpitis in him. But what is pulpitis? What are the main methods and stages of treating pulpitis in a child and an adult?
Pulpitis - what is this pathology?
Pulpitis is an inflammation that affects the neurovascular bundle (pulp). One of the most common causes of inflammation is tooth decay, which contributes to the destruction of hard tooth tissues. Pathogenic bacteria that fill the carious cavity provoke the inflammatory process of the pulp (in the people it is called a nerve).
Pulpitis can also develop due to poorly performed filling procedures or tooth injuries. There are several types of pulpitis, each of them requires first aid from a specialist. Methods and stages of pulpitis treatment for each type are selected individually.
Types of Pulpitis
In the initial form of pulpitis, the reaction of the pulp to irritation is hyperemia, during which the blood flow in the pulp arteries increases significantly. The amount of blood inside the cavity increases and thereby creates pressure on the small fibers of the nerve, which leads to aching pain. After the irritation is removed, the pain immediately passes.
The acute form of pulpitis is accompanied by severe pain. If the pulp is not yet severely inflamed, then the process can be stopped, in which case the pain immediately goes away. The pulp can be cured on its own, it is only necessary to remove the causes of irritation.
In the event that the pulp does not recover on its own, the pain continues to bother and becomes even more acute, especially intensifies at night, then there is no way to do without the help of a dentist. On examination, a tooth with a deep carious cavity and a painful bottom during probing is revealed. The stages of pulpitis treatment in this case are selected depending on how much the tooth is affected and whether the inflammation has gone further.
The purulent form is one of the most severe and is characterized by sharp pain, which intensifies at night, and it does not work to weaken it with painkillers.
The chronic form of pulpitis is characterized by seizures, if an irritant appears, and if it is eliminated, then the pain goes away. Dull pain can last long enough. During the examination, a deep cavity with caries and bleeding is revealed.
Chronic hyperplastic pulpitis is an irreversible form requiring serious stages of pulpitis treatment. In children and youth, this form is much more common. It is represented by hyperplasticized pulp tissue called a pulp polyp.
Necrosis refers to irreversible forms of pathology, it is characterized by the death of the pulp, appears after prolonged bacterial invasion, or is the result of acute purulent pulpitis.
Pulpitis Symptoms
Pulpitis is a very serious disease that requires a quick response and seek qualified help. If the initial stage of the disease is accompanied by aching pain, which can be relieved by taking painkillers, then acute and chronic pain causes severe pain, which intensifies at night and does not subside even after taking the medication.
During exposure to tooth irritants - thermal, mechanical or chemical - the pain intensifies. If therapy is not started in the acute phase of the pathology, then in the end everything will end in a chronic form, which is characterized by pain when the tooth touches, it intensifies when exposed to hot products, and weakens from cold ones. If you do not take any measures and do not begin to carry out the stages of treatment of pulpitis, then inflammation can affect the bone structures of the jaw.
Why is pulpitis treated?
If you imagine a person who is constantly busy with problems at work or in the family, then he does not always immediately pay attention to a slight pain in the tooth. The first thing he does is take the pain medication: Ketanov, Nurofen, Ketorolac, Baralgin, Nise, and forget about the problem. But over time, the bacteria that remain in the pulp chamber of the tooth continue to destroy it and eventually lead to the appearance of pus in the root canal.
After the pus extends beyond the root canal, a flux appears, and it can manifest itself not only in the form of a slight swelling of the gums, but also in the form of a strong swelling with a severe violation of symmetry. Severe forms of pathology require taking serious steps in the treatment of pulpitis, otherwise it can threaten not only tooth loss, but also pathologies such as phlegmon, blood poisoning and bone damage.
The main stages of endodontic treatment
The initial form of pulpitis can be cured very quickly, one appointment with the dentist is enough, but with serious forms, a long treatment of pulpitis of the tooth is required . The stages of therapy will require a few doctor's appointments from the patient, and each of them is designed to relieve pain, disinfect the cavity of the tooth and others, but first things first. When root canal therapy, it is important to follow the steps:
- The stages of treatment of pulpitis, the photo confirms this, begin with anesthesia, the doctor isolates the tooth from saliva using a thin sheet of rubber - rubber dam, which is applied around the diseased tooth.
- Next, the channel is cleaned of bacteria. Access to the channel is provided by dissecting the cavity, removing the roof of the pulp chamber, creating free access to the channels for the instrument.
- Canal cleaning involves mechanical and chemical disinfection.
- Next, file processing is performed along the entire length of the root canal, but not beyond it, therefore it is very important to determine the length of the channel, for this, files are first inserted, and then an x-ray is taken.
- The doctor carries out chemical disinfection with special needles of single use.
- After the canal is completely cleaned, the doctor begins to fill.
Filling is the last action of the dentist, completing all stages. But the treatment does not end there, the doctor still recommends carrying out some procedures that will effectively deal with inflammation and help protect against relapse.
Appointments after the first stage of treatment
After the doctor has treated pulpitis, its stages are completed, you will need to take medications and procedures at home for several days:
- Physiotherapy is the use of a laser, in this case it is best to carry out the procedure on a helium-neon device. Only a few procedures will be enough to consolidate the therapeutic effect and prevent relapse.
- Taking medication. Since pulpitis is inflammation, it is simply necessary to undergo a course of non-steroidal anti-inflammatory drugs, such as Ibuprofen, in order to completely remove the inflammatory process.
It is very important to monitor a patient, for example, a child, after he has undergone all the stages of treatment for pulpitis of primary teeth, it is very important to monitor his condition, and if there are complaints, then immediately consult a doctor. A child can not always independently determine what is happening to him, so the doctor advises parents to watch him or just come to a control appointment, after a few days.
Pulpitis vital amputation method
There are several methods of treating pulpitis, one of them is vital amputation, which involves the preservation of pulp only in the channels of the tooth, but in the crown area it is removed. This technique is undertaken if a multi-root tooth is affected. This method is not used for the treatment of a single-root tooth, but all because there is no border between the coronal and root zones of the pulp. This technique consists of the following steps:
- local anesthesia is performed;
- areas affected by caries are removed;
- pulp is removed;
- the cavity of the tooth is treated with drugs;
- a medicinal pad is applied to the channel;
- then impose an insulating pad;
- temporary filling.
After this procedure, the doctor also recommends treatment with a laser and anti-inflammatory drugs.
Surgical treatment of pulpitis
There are several treatment methods for pulpitis, including an operational approach. This method involves the removal of a nerve, and this occurs both in the coronal and root zones. This method is called depulpation. It is used with advanced forms, in which it is necessary to take all measures to begin the treatment of pulpitis, the stages consist of the following manipulations:
- all tissues affected by caries are drilled;
- the nerve in the coronal and root parts is removed;
- the channels where the nerve was located are carefully processed;
- after the canals are sealed, and after the crown part.
It is worth remembering that at one time the doctor will not be able to carry out all the procedures at once, so you need to be prepared for the fact that there will be two, or maybe three, visits.
Now consider in more detail all the stages of treatment.
Pulpitis Treatment Steps: Doctor's First Visit
So, in order to accurately understand all the stages of pulpitis treatment, you need to know how everything happens and how the dentist treats:
- Most often, the patient seeks help at a time when he is worried about severe pain, which does not stop even after taking painkillers, so the doctor immediately makes anesthesia.
- After the injection has an effect, they begin to eliminate the tissues affected by caries, for this they use a drill, which allows them to be drilled.
- After this, it is necessary to establish a rubber dam so that saliva with bacteria does not enter the purified canal.
- Then pulp is removed using a pulp extractor, this tool is very thin and with small notches that help to pull the pulp out of a thin channel.
- Next, you need to accurately measure the root canal in order to completely fill it and thereby protect against complications. To do this, an x-ray is taken, there can be several channels in the tooth, which means that everyone needs to be measured.
- After all the channels are treated with antiseptic solutions and a temporary filling is established.
The first visit will be over, although it is often not always the first time that all this can be done, the first visit may result in anesthesia, reaming of the channels and laying the medicine in them to kill nerve sensitivity.
Subsequent and final visits
But the second visit to the doctor provides for such stages of pulpitis treatment:
- The doctor removes the temporary filling, and then the medicine from the canals.
- Then the channels are washed with antiseptics.
- A seal is installed, for this use gutta-percha pins and sealer.
- Then they carry out an x-ray to check how well the channels are sealed.
- If the x-ray showed that everything is fine, then you can put a seal.
But not only adults suffer from pulpitis, it also often worries children who do not yet have molars, but only milk. Pulpitis treatment in children of primary teeth stages has simple, only partially similar to the treatment of indigenous. But parents should remember that inaction and untimely treatment can lead to complications.
Stages of treatment of pulpitis of deciduous teeth in children
Often the pulpitis in the child proceeds in a severe form, therefore, in this case, the doctor can recommend the removal of the milk tooth, but still if there is even the slightest opportunity to save it, while the bite does not suffer, then they begin treatment. Stages of therapy for pulpitis of primary teeth:
- On the first visit, the doctor opens the nerve and applies a paste that has a devitalizing effect, it helps to kill the pulp. If arsenic is present in its composition, then it can be kept for no more than 2 days, and the product without arsenic can be kept for up to 7 days.
- At the next visit, a special substance is pumped into the tooth to mummify the infected pulp, most often it is a resorcinol-formalin mixture.
- On the last visit, a permanent seal is established.
Pulpitis treatment is a simple procedure if you seek the help of a doctor in time. Moreover, today, thanks to modern technologies and effective means, a bad tooth can be cured very quickly.
You should not sit until the last moment and wait until the pain becomes completely unbearable, it is better to visit the dentist regularly, then you will not have to endure the pain and remove the tooth.