How to relieve toothache due to pulpitis - recommendations from doctors

Our teeth are not only dense organic tissues covered with hard tooth enamel. Hidden inside each tooth is a complex system of blood vessels and nerve endings, which is necessary to maintain the health of the dentition. The sensitivity of soft tissues in the oral cavity is tens of times greater than the sensitivity of other organs. Therefore, any infection that gets inside the tooth causes inflammation and severe pain. Pathology is also provoked by temperature changes: burns or hypothermia. Unbearable pain forces a person to treat pulpitis and seek help from a dentist.

Will we treat him or let him live?

Often the fear of doctors forces us to make do with improvised methods. We take painkillers, fast, endure, in the hope that the sharp pain will go away on its own. Is it really possible to “wait out” an exacerbation, or is it better to get professional help in time? Let's figure it out.

To find the right method of treating a disease, you need to know the origins of its occurrence. The core of the tooth, or pulp, is responsible not only for tooth sensitivity, but also for the production of dentin. The tissue strengthens the tooth from the inside.

The anatomical features of the pulp depend on the type of teeth. In the lateral row, as a rule, there is a chamber with three dental canals. The front row and incisors each have one branch. It is logical that molars are much more difficult to treat than canines or premolars.

Pathological changes in the pulp tissue form swelling, causing unbearable pain. The pain intensifies upon contact with hot food or when pressing on the tooth.

Acute pulpitis

Acute pulpitis, as we have already said, is characterized by severe toothaches that occur WITHOUT a reason and intensify at night. The main symptomatic difference between acute pulpitis and caries is that pain in deep caries is always associated with an irritant, and stops when the action of the irritant is interrupted. The pain associated with pulpitis is pulsating, not associated with impact on the tooth, is difficult to relieve with tablets, and radiates to the ear, jaw, and temple. It is difficult for the patient to determine which tooth hurts; usually he complains that half of the jaw hurts.

There are several forms of acute pulpitis, depending on the location and manifestations of the inflammatory process:

Prerequisites

The most common cause of inflammation of the dental nerve (pulp) is the presence of caries. And in a deep stage. The infection reaches the soft tissues through the destroyed tooth tissue, provoking an inflammatory process. A similar situation occurs when a filling falls out or is damaged, when the pulp is “exposed.”

Bacteria can enter the tooth cavity from another source of infection in the body. Inflammation also occurs when a tooth is injured, minerals accumulate in the pulp, or low-quality components are used when filling canals.

Also, treatment of pulpitis may be required if the nerve overheats during preparatory procedures for prosthetics. If there is increased sensitivity, swelling of the pulp can be caused by the use of chemicals during therapy. It is also possible that an infection may accidentally enter the pulp chamber when eliminating a carious cavity.

How does pulpitis form?

Pulpitis refers to inflammatory processes that develop in the pulp – the neurovascular bundle. The inflammation itself can be a consequence of mechanical damage to the pulp, for example, as a result of mistakes made by the doctor during canal filling, or injury after a blow or fall.

However, almost always pulpitis becomes the result of severely advanced caries, in which pathogenic bacteria from the carious cavity penetrate into deeper layers and reach the pulp. It is they who cause the rapid destruction of the neurovascular bundle - this is how pulpitis develops, and irritation of the nerve endings provokes acute pain.

Important! The best decision that can be made in case of pulpitis is to immediately consult a doctor. Even better is to make a visit to the clinic, where the treatment will be carried out using a microscope. This optical magnifier will help preserve the tooth for many years and eliminate the risk of re-inflammation. With a microscope, you can remove the nerve without leaving any residue, efficiently pass through, process and fill the root canals without damaging healthy tissue or perforating the root walls. In addition, the device allows you to save a tooth and correct mistakes made by unqualified doctors earlier: using the device, you can carefully remove tool remains from the roots, refill canals, close holes and perforations.

Phases of the disease

Classification of any disease contributes to quick and correct diagnosis and selection of an effective treatment method for the patient. In the case of pulpitis, everything is relatively simple, there are only two subtypes - acute and chronic.

The first type of inflammation occurs with advanced forms of caries. Bacteria destroy tooth enamel and dentin, and the infection enters the pulp. The disease is accompanied by aching, sharp pain, which intensifies with mechanical or thermal effects on the tooth. Severe pain attacks may occur at night.

Interestingly, only adults are susceptible to acute pulpitis. The anatomical structure of a child’s jaw protects him from illness.

This type can be focal or diffuse. Focal inflammation is characterized by local damage to the pulp, located close to the carious cavity. Accompanied by throbbing pain around the affected tooth. Lasts approximately 2-3 days.

Then the process moves to the next stage - damage to all tissues of the dental nerve. The pain syndrome changes from pulsating to constant, unpleasant sensations spread to the entire jaw. Pus forms in the tooth cavity. The phase lasts no more than two weeks. If timely treatment of pulpitis is not started, the pathology enters the chronic stage.

Lotions, rubbing and other procedures

Treatment of dental pulpitis with folk remedies also involves other methods of therapy:

• mouth baths;
• lotions;
• compresses;
• rubbing.

Mouth baths

Almost all decoctions and infusions that are used for rinsing can also be used for oral baths. Place a warm but not hot solution in your mouth, hold it, and spit it out. Repeat every one and a half to two hours.

Lotions and compresses

Soak a cotton pad or gauze napkin in the healing decoction, squeeze lightly, apply to the gum near the tooth affected by pulpitis, and hold for several minutes. Repeat 3-5 times a day.

Rubbing

Apply a paste or cream prepared from medicinal natural ingredients to the gums and rub in with light massage movements until completely absorbed.

You should not overuse rubbing, as they can cause irritation of the mucous membrane; 2-3 procedures per day are enough.

Eliminate cannot be deleted

A term that patients in all fields of medicine fear is chronic disease. Let's see what the consequences are in our case. Inflammation of the dental nerve with chronic pulpitis lasts from a month to several years. The pain syndrome remains, but becomes less pronounced. Seizures occur periodically. The patient can no longer chew on the side of the diseased tooth. The affected nerve begins to bleed and dentin continues to deteriorate. Chronic pulpitis is also characterized by several phases:

• Fibrous. Relatively “easy” stage. It occurs when carious tissues are not located close to the dental nerve. Unpleasant sensations occur only when you press on the tooth.
• Gangrenous. The pulp tissue is completely infected. The nerve changes color. The pain becomes more noticeable. The tooth is deeply affected by caries.
• Hypertrophic. Bacteria destroy the tooth down to the pulp chamber, connecting both cavities. A polyp grows in the vacated space, causing the nerve to bleed. The pain syndrome persists.
• Exacerbation. The final stage of the disease, when the patient is attacked by periodic attacks of pain, combined with constant aching unpleasant sensations. Pus appears in the tooth cavity, inflammation spreads to the tooth root, and periodontitis develops.

In 90% of cases, doctors treat fibrous pulpitis, less often - the second stage. In general, chronic inflammation is an irreversible process. The only solution is to remove the damaged dental nerve.

General recommendations

First of all, you should follow a number of recommendations to help relieve painful symptoms:

• Periodic rinsing with warm water in the absence of purulent discharge or cool water in the presence of it can relieve severe attacks of pain;
• If any irritants (hot or cold food, sour liquid, pieces of candy) come into contact with an inflamed tooth, they must be removed as quickly as possible to eliminate the pain;
• Avoid chewing food on the same side of the jaw where the sore tooth is located;
• Sleeping on the sore side is not the best solution, because the flow of blood increases blood circulation in the inflamed pulp, which automatically increases pain;
• For pregnant and lactating women, the only way to relieve pain from pulpitis is paracetamol and folk remedies that are not contraindicated for a child;
• If you have not previously had negative reactions to strong painkillers, drugs such as ketanov, ketonal, baralgin, pentalgin-N, and nurofen will provide almost immediate help. However, you should not take them immediately before going to the doctor, otherwise the picture of the disease will be blurry and the dentist will not be able to make a correct diagnosis. It is also impossible to replace the treatment of an inflamed pulp with constant use of painkillers, otherwise the acute form of the disease will soon become chronic with a huge number of complications and consequences. And for health, frequent, uncontrolled use of painkillers is very harmful;
• Do not apply analgin to a sore tooth under any circumstances! This will not bring relief, but it can cause harm to soft tissues and destroy tooth enamel;
• But applying a cotton swab moistened with two or three dental drops is very worthwhile, since they have a positive effect on the inflamed tooth;
• Another medicine that helps with pulpitis is dimexide. It is anti-inflammatory and is actively used by doctors in treatment in the form of applications to the diseased area. True, this drug also has several unpleasant sides. Firstly, it has a terrible smell that causes disgust and nausea. Secondly, allergic reactions occur quite often when using it, so if you have not previously had experience using dimexide, it is better not to risk it.

Survey

To determine an accurate diagnosis, the dentist conducts an initial examination. Because If pulpitis develops against the background of other diseases, then diagnosis includes 4-5 stages. The procedure begins with communication with the patient. It is important to understand at what stage the inflammation is, which is especially important in chronic pulpitis. Therefore, the doctor asks you to describe in detail the nature of the pain. Then a “manual” examination is carried out using medical instruments (dental mirror, etc.). Additionally, the doctor checks the sensitivity of the affected tooth for temperature changes and exposure to a weak electric current charge.

The examination is completed by an X-ray examination to assess the condition of the dental nerve and canals. After collecting information and analyzing the image, the doctor plans the pulpitis treatment process and coordinates it with the patient.

How to deal with the disease

At the initial stage, it is not difficult to cope with pulpitis. The nerve in the tooth is preserved, and the doctor relieves the inflammation using therapeutic procedures.

The biological treatment method eliminates inflammation through antibacterial treatment of the damaged tooth, without removing the nerve. After removing carious tissue and disinfecting the pulp chamber, the dentist applies a compress with calcium hydroxide and fixes a temporary filling.

Then, after 3-7 days, during a follow-up visit, the doctor takes an x-ray. If there is no inflammatory process, then a permanent filling is installed. However, this technique requires a highly qualified doctor, so it is rarely used. For example, with traumatic inflammation of the dental nerve.

Preserving the pulp is important because... If it is present, the tooth is constantly strengthened due to the production of dentin. Conservative therapy has age restrictions - it is carried out up to 30 years.

Stages of pulpitis treatment

The surgical method of treating pulpitis is based on complete removal (extirpation) of the pulp followed by filling the root canals of the tooth.

The surgical method is most often used in clinical practice for the treatment of both acute and chronic pulpitis. This method consists of several stages.

The vital method of treating pulpitis is the treatment of pulpitis without the use of arsenic; the nerve is removed under anesthesia. Under local anesthesia, carious tissue is removed and the tooth cavity is opened. Then the inflamed, infected pulp is removed. The root canals of the tooth are carefully processed with special (endodontic) instruments in order to remove residual pulp and remove a layer of infected tissue from the inner surface of the root canals. During mechanical treatment, the crown canals of the tooth are repeatedly washed with antiseptic solutions (chlorhexidine, sodium hypochlorite, etc.). This is especially important in the treatment of gangrenous pulpitis, when pulp necrosis and infection of the tooth root occur.

Treatment of pulpitis is often carried out with preliminary temporary filling of the root canals with anti-inflammatory antiseptic pastes. And only then the roots of the tooth are finally filled.

The devitalizing method of treating pulpitis is based on the use of devitalizing agents. Simply put, the nerve is killed using arsenic or less toxic non-arsenic agents. The devitalizing agent is applied for several days, after which the insensate nerve is removed.

The final stage of pulpitis treatment is filling the root canals of the tooth. Modern methods of treating pulpitis provide both complete treatment of the root canals of the tooth and subsequent hermetic filling (obturation).

When filling root canals in the treatment of pulpitis, there are several main methods:

• method of lateral and vertical condensation of cold gutta-percha (filling tooth canals with gutta-percha);
• filling the root canals with softened (heated) gutta-percha;
• filling with heated gutta-percha on a carrier (filling root canals with Thermofil).

Along with the traditional method of root canal treatment and filling using the “lateral condensation of gutta-percha” method, our clinic can offer you innovative technologies in the treatment of pulpitis and periodontitis. In this case, nickel-titanium rotating instruments are used to treat the root canals of the tooth - the latest word in dentistry. When using such instruments, the quality of root canal treatment is significantly improved due to the increased taper of the instrument and its high cutting efficiency. Working with such instruments requires special skills from the doctor, and indicates his high qualifications.

After such treatment, as a rule, heated gutta-percha or “Thermafil” is used to fill the root canals. With these methods of canal filling, three-dimensional obturation occurs, including small branches in the canal, which, accordingly, increases the quality and reliability of treatment, and also allows us to hope for a very positive prognosis for the further functioning of the tooth.

Partial and complete nerve removal

Partial extraction of the pulp is also acceptable if the coronal component of the nerve is separated from the root. To prescribe surgery, there must be a large volume of intact periodontal tissue.

The procedure is performed under anesthesia for patients under 45 years of age.

In practice, pulpitis is treated surgically. The nerve is completely removed, which saves the patient from relapse and re-treatment.

Pulp removal occurs in two ways:

• Extraction of living nerve.
• Preliminary killing of the pulp (devitalization) with further removal.

In the first option, all work is carried out in one session. The dentist removes the affected tooth tissue, thoroughly disinfects the cavity, and then removes the inflamed nerve. At the final stage, a filling is installed.

If it is not possible to remove the living nerve from the tooth, it is treated with medical paste made from arsenic or paraformaldehyde. After 1-2 days, the pulp dies and is painlessly removed. Patients cannot always visit the doctor the next day; in this case, the dentist fixes a less concentrated composition for up to two weeks. A temporary filling is placed on top. During the next visit, the doctor treats the canals with an antiseptic and fills the tooth. Important: this method of treating pulpitis is not applicable in the presence of pus and dead tissue in the pulp.

Complications in the treatment of pulpitis

Although diagnosing pulpitis is not difficult and dentistry has everything necessary for the treatment of pulpitis complications still occur . For example, if a tooth hurts after treatment for pulpitis , this is often due to insufficient antiseptic treatment of the root canal before filling it. Inexperienced dentists may make mistakes when treating pulpitis, which cause pain after pulpitis treatment.

Complications in the treatment of pulpitis include incomplete filling of the root canal; removal of the filling material beyond the apex of the tooth root.

Less common complications of pulpitis treatment are:

• undetected and, accordingly, not sealed additional root canal;
• fracture of an endodontic instrument in the root canal;
• perforation of the root canal wall or tooth wall.

How is therapy carried out?

The process of extracting the dental nerve may require 2-3 visits, depending on the number of roots in the tooth. The time interval between sessions is prescribed by the doctor, in accordance with the diagnosis.

Traditionally, treatment of pulpitis consists of 4 stages:

• Application of local anesthesia. Nerve endings are very sensitive to any impact, so painkillers are indispensable.
• If caries is present, the affected tooth tissues are first removed. Sometimes it is necessary to remove a healthy part of the tooth to gain access to the pulp.
• Using a special tool, a pulp extractor, the dental nerve is extracted. Depending on the stage of the disease, the pulp is pre-treated with arsenic or extracted alive.
• The dental canals are measured and thoroughly disinfected.

After treatment, the tooth is filled: first the root canals, then the upper, coronal part of the tooth. In difficult cases, for example, with chronic pulpitis, the doctor fixes filling materials only in the canals in order to track a possible relapse of the disease. If inflammation reappears, then intermediate therapy is prescribed using antibiotics.

After installation of a permanent filling, the patient may experience pain. This usually lasts no more than 2-3 days, with a reaction to cold foods and drinks. If the discomfort continues, then the inflammatory process has resumed, and you need to visit the dental office as soon as possible.

What to do if tooth pain persists

According to Dr. Bobkova, patients may experience pain when chewing after root canal filling. However, there is nothing wrong with this phenomenon if the unpleasant sensations disappear after two or three days.

“If the pain has been bothering you for a week or more, then you should consult your doctor. There can be several causes of pain - a fracture of the instrument, perforation in the tooth wall, removal of material beyond the apex of the tooth, or an additional canal was missed during the treatment process. Therefore, you cannot endure the pain; it is better to immediately contact your doctor.”

Children's horror stories

The phases of disease progression at a young age are approximately the same. But unlike adults, children's pulpitis develops many times faster. A small hole in the tooth is enough for the infection to cause inflammation in the pulp chamber. Accelerated pathological processes can lead to infection of the soft tissues around the tooth, which can lead to problems with the growth of molars. Therefore, if a child complains of toothache, it is important to consult a doctor immediately.

The question often arises: is it possible to treat pulpitis or is it still necessary to remove the dental nerve in children? An experienced dentist always strives to preserve both the baby tooth and the pulp. Because the absence of teeth in a row can affect the location of neighboring teeth, change the bite, and even diction.

In the case of baby teeth, the dentist uses special filling materials that dissolve over time and do not interfere with the growth of the permanent dentition.

Gentle drugs that are hypoallergenic and safe for babies are used as pain relievers.

Pulpitis in children

Treatment of pulpitis in children follows the same scheme, but there are a number of difficulties here. Firstly, the inflammatory process in the tooth itself occurs very quickly, so it is important to prevent it from spreading to the bone tissue around the tooth. Secondly, a child may experience an allergic reaction to anesthesia during treatment.

Therefore, in the case of children, it will be much easier to initially monitor the condition of the teeth and prevent the occurrence of caries. If your child complains of toothache, you should not put off visiting the dentist. After all, the health of permanent teeth depends on the speed of treatment.

Probably no one wants to get such dental problems. To avoid them, you need to visit the dentist once every six months, have an examination and professional cleaning, eat right, give up bad habits and keep your mouth clean. After all, dental health is only in your hands.

Indications during pregnancy

There is a myth that it is impossible to treat teeth while expecting a baby. This misconception can have serious consequences. Infection, for example in the form of caries, through blood vessels can spread throughout the body.

It is also a mistaken belief that x-rays harm the development of the fetus. It has been proven that modern equipment has a minimal radiation dose that does not affect the body. It is much more dangerous to bring the inflammatory process to a chronic state. Therefore, you should not delay treatment of pulpitis or caries when symptoms appear.

The process of bearing a child is associated with a decrease in immunity, and as a result, with increased sensitivity to bacteria and infections. Tooth enamel in pregnant women is not as strong, because... All nutrients are aimed at the growth of the baby. Therefore, the appearance of pulpitis and deterioration in the condition of the dentition is a normal phenomenon.

The second trimester is considered the optimal period for receiving dental care. During this period, the child is protected by the placenta from harmful substances. However, if an inflammatory process occurs in the dental nerve, it is not recommended to delay treatment so as not to expose the baby to unnecessary risk.

During pregnancy, the doctor chooses a gentle treatment method, when the filling is fixed only in the dental canals. If possible, without the use of anesthesia. After childbirth, the patient is given a permanent filling. X-ray examination is carried out only in emergency cases.

What does traditional medicine offer?

Folk remedies can reduce the growth rate of pathogenic bacteria and protect healthy teeth from their spread. In addition, some home recipes can reduce unpleasant painful sensations. Below are the most common and proven traditional medicine.

Medicinal tinctures

Calendula and sage significantly relieve pain due to their calming effect. It is enough to mix two collections (1-2 spoons each) and pour a glass of boiling water. Leave for half an hour and strain. Rinse or hold in mouth every 2 hours for 3-5 minutes. Willow bark also helps well - a spoonful of the mixture is required for 100 ml of boiling water. Leave for two hours. Next, you need to take fifteen-minute baths every two hours - just take the infusion into your mouth and hold it for several minutes, then spit it out. You can also chop ginger, about 30 grams per 100-150 ml of hot water. You need to infuse the mixture for half an hour, after which you need to pass it through cheesecloth and add a teaspoon of soda. Do baths every 2 hours for a couple of minutes. This composition perfectly relieves inflammation.

Calendula tincture will relieve pain

Decoctions for pain relief

You can take two fruits, peel them, chop them and place them in a 1-liter container. Next, pour boiling water over the whole thing, and then simmer over low heat for two hours. The resulting decoction is used to rinse the mouth 5 times or more during the day.

Therapeutic baths and lotions

Celandine helps relieve pain. The greens need to be thoroughly washed, chopped and squeezed out the juice. Next, prepare a saline solution at the rate of 2 teaspoons of salt per 200-250 ml of warm water. Mix the resulting solution with celandine juice (2-3 teaspoons). Then every 2-3 hours you need to rinse your mouth with this solution for literally a few minutes. You can also peel an aloe leaf to pulp and apply it to the affected area for 10 minutes every 2 hours.

Rubbing and applications

As practice has shown, a thick paste made from pre-dried and ground banana skin, coarse sea salt and olive oil has proven effective in relieving acute symptoms of the disease. The surface of the gums is treated with this composition and kept in the mouth for 10 minutes. It is recommended to do this twice a day - after waking up and before going to bed. It is also advised to apply a piece of black bread or lard without salt to the inflamed area. These products are believed to help relieve acute soreness.

Important! Many people on the Internet are looking for an answer to the question: how to treat pulpitis at home? Remember: it is impossible to cure the disease using traditional methods. A set of such measures can only be aimed at relieving symptoms before going to the dentist. The danger lies in the fact that the incorrect use of such methods can even lead to the formation of pus, as well as its rapid spread throughout the body. Before you start rinsing, it is better to consult a specialist.

But what else can be done to quickly numb the tooth before arriving at the dentist? To relieve pain, you can take a pharmaceutical pain reliever, for example, Pentalgin, Ibuprofen, Ketonal or Ketorol. To avoid negative reactions to drugs, it is recommended to consult your doctor in advance.

Pharmacy painkillers will help relieve pain

Inflammation of the nerve in the wisdom tooth

Eights have their own specifics, and the doctor often chooses to remove the tooth. The complexity of therapy is due to the anatomical features of the third molars. Curved roots, lack of access to the tooth, partial overlap of the gums equates the treatment of pulpitis in figure eights to jewelry work. And it requires experience and high qualifications of a doctor.

An inflamed nerve in a wisdom tooth can be treated by filling the canals. Provided that there is access to the root and the dental canals have good patency. It makes sense to preserve a tooth in the presence of an antagonist tooth, if the tooth is involved in the chewing process and is used when installing a prosthesis.

Chronic pulpitis

Chronic pulpitis occurs if acute pulpitis is not treated. At some stage, acute pain subsides, but destructive processes in the pulp continue. The infection lies dormant and makes itself felt by periodic “shots” in the presence of hot, cold, sour, and sweet foods. Pain occurs when pressing on a tooth. At any moment, acute inflammation may begin again or the disease may be aggravated by a new complication.

Chronic pulpitis also has several forms:

Pulpitis of the wisdom tooth

Pulpitis can affect all teeth without exception. But eighth wisdom teeth have an increased risk of pulpitis. They are located far away, it is difficult to clean and treat them, so inflammation of the pulp in third molars occurs more often. Treatment of pulpitis of eights is also complicated by their inconvenient location and numerous roots. The risk of complications during endodontic treatment increases and the long-term prognosis for these teeth worsens. So in the case of acute pulpitis of a wisdom tooth, it makes sense not to treat such a tooth, but to remove it immediately.