Health is undoubtedly the most important component for any person. We all try to keep an eye on him, but quite often something happens that bothers us. We don’t immediately turn to a specialist, but it’s really in vain.
So, if you are often bothered by your wisdom teeth, and you don’t know if you need to treat them or remove them immediately without suffering, then you should read this article. You can easily throw unnecessary information aside and make the right choice. Let's take a closer look at what's what and dot the i's.
What is special about wisdom teeth?
The maximum set of molars for an adult is 32. In this case, it is considered normal to have 28 teeth, since four teeth are the so-called eighth molars or wisdom teeth. For some, they do not erupt at all, for others, when “eights” appear, complications and pathologies arise, but in other cases, wisdom teeth occupy the correct position in the dentition and do not bother their owner. “Eights” usually appear between the ages of 17 and 27, that is, during the period when a person has already formed an attitude towards hygiene and his own dental health. Why is it important? Due to the remote position of wisdom teeth, it is quite difficult to carry out high-quality cleaning, so only very good hygiene can reduce the risk of dental damage. In reality, it is the third molars that are in the top in terms of the number of cases of caries and its common complication - pulpitis.
Pulpitis of the tooth due to poor quality of caries treatment
Poor treatment of caries can cause the development of pulpitis. In order to treat a carious tooth correctly, a specialist must remove all tissue damaged by the disease during work, and then check the quality of the manipulations performed with a special caries detector. If at least one area with destroyed tissues was missed, the drug will paint it a bright color. However, some specialists neglect the verification stage and treat the tooth without using detector drugs.
Such an unscrupulous approach is fraught with relapse of caries: the disease will continue to develop and destroy dentin, and ultimately bacteria will penetrate into the pulp chamber, causing tooth pulpitis.
Pulpitis of the wisdom tooth: symptoms and treatment
Pulpitis affects the connective tissue of the tooth - the pulp. It has a crown and a root part: depending on the shape and degree of the disease, one or both parts may be affected. The symptoms of wisdom tooth pulpitis are exactly the same as in the case of other teeth.
- Painful sensations.
In acute pulpitis, the pain is acute and paroxysmal, and can be felt in the temples, ears and other parts of the jaw. The pain intensifies at night and when exposed to irritants (temperature, chemical or mechanical). With chronic pulpitis, the pain is dull and less pronounced, which makes it difficult to diagnose the disease, given the location of the wisdom tooth;
- Bleeding.
It appears only in chronic hypertrophic pulpitis, when granulation tissue grows;
- Change in tooth color.
Observed in the case of tissue necrosis with gangrenous pulpitis.
When a wisdom tooth hurts, pulpitis is just one of the options that could be the cause. To diagnose pulpitis, a visual examination, x-ray or EDI (electrodynamic diagnostics) is required. Of course, such procedures are carried out only by professionals, so if you suspect pulpitis, you should immediately make an appointment with a doctor. Most patients who face a similar problem have two questions: is wisdom tooth pulpitis treated and is it worth treating wisdom tooth pulpitis. The answer to the first question is yes, but to answer the second, you need to consider each clinical case separately.
Forms of acute pulpitis
The cause of acute pulpitis is caries, the treatment of which was not carried out in a timely manner. This form is characterized by pronounced symptoms: the patient is bothered by unbearable throbbing pain, the intensity of which is especially high at night. Acute pulpitis can occur in two different forms: focal or diffuse.
Focal pulpitis of the tooth
It is the initial phase of the disease, lasting an average of 2 days. A person with focal pulpitis may experience severe shooting pains, which manifest themselves both under the influence of external factors and without impact on the tooth. The average duration of one attack is from ten minutes to half an hour. Afterwards the pain may stop, but after a while it will return. With focal pulpitis, the pain has a clear localization, that is, a person can always tell the doctor which specific tooth is bothering him.
Diffuse form of acute pulpitis
If you ignore the symptoms of focal pulpitis and do not go to the dentist for its treatment, after two days the pain will lose its clear localization and will begin to radiate to the cheekbones, occipital or temporal zone. The duration of painful attacks will increase - up to forty minutes, and the intervals between them, on the contrary, will be significantly reduced.
With this form of pulpitis, the inflammatory process moves from the coronal part of the pulp bundle to the root. If at the same time purulent fluid begins to be produced, the pain will be severe and incessant. A cold compress can help reduce the intensity of pain, but consuming hot food and drinks and heating the area of the diseased tooth should be avoided in every possible way - this is fraught with the active development of inflammation. With a diffuse form of pulpitis, body temperature may even rise.
If diffuse pulpitis is not treated, after some time it will become chronic.
Fibrous form of chronic pulpitis
Fibrous pulpitis often does not show itself in any way for a long time. The person does not complain of pain or other discomfort. However, at the same time, there is significant carious destruction in the tooth, during which a cavity of great depth is formed. If you press on its bottom, a sharp pain impulse occurs. Pain does not appear during the development of the disease precisely because of the presence of a large cavity through which the outflow occurs, which accumulates during inflammation of the fluid. However, there is no point in hoping that in this case you can wait to treat pulpitis. Over time, the pulp tissue will begin to die, and inflammation will spread to the roots of the tooth, which will ultimately lead to the need for its removal.
Gangrenous form of pulpitis
The reason for the appearance of this form of the disease is pathogenic microflora, which causes the gradual death of nerve fibers in the pulp. The pulp bundle changes its color, becomes grayish, and a rotten smell appears in the mouth.
Hypertrophic form of acute pulpitis
With this form of pulpitis, the carious cavity connects with the tooth cavity, in which connective tissue begins to actively grow. This process leads to the formation of a polyp, which will fill the entire space; if you press on this formation, it will begin to bleed. However, patients rarely complain of pain. USEFUL TO KNOW: an exacerbation of chronic pulpitis can occur at any time. At this phase, the pain does not stop for a minute and does not subside after taking painkillers. Only a visit to the dentist’s office can help for high-quality and effective treatment of pulpitis.
Pulpitis of the wisdom tooth: treat or remove?
In most cases, a wisdom tooth with pulpitis is removed. The main indications for removing a diseased “eight” are developmental pathologies, as well as being outside the bite (in this case, the tooth has no function). We are talking, first of all, about retention and dystopia. An impacted wisdom tooth is completely or partially hidden in the jaw, and a dystopic wisdom tooth has an incorrect position relative to the rest of the dentition. These pathologies in themselves are a good reason for removing the “eight”, however, if pulpitis occurs due to the impossibility of full treatment, such teeth are definitely removed.
Pulpitis: what kind of disease is this?
With dental pulpitis, the internal tissues of the tooth become inflamed, which in medicine are referred to as “pulp”. The pulp is located partly in the coronal part of the tooth and partly in the dental canal and consists of nerve, connective tissue cells and microvessels. The pulp performs an important function: it provides nutrition to the dentin of the tooth with substances necessary for its health. The process of inflammation in the pulp begins with the penetration of pathogenic microflora into the tooth and most often this happens due to untreated caries.
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Caries destroys the hard tissues of the tooth, resulting in the formation of deep cavities, from which infection easily enters the pulp chamber and dental canals. This is how pulpitis occurs, the onset of which can be indicated to a person by increased sensitivity of the tooth to cold and hot, and throbbing pain. Less commonly, pulpitis occurs for other reasons, including: periodontitis, poor-quality tooth treatment for caries, poor-quality tooth grinding during prosthetics.
Treatment of wisdom tooth pulpitis
Treatment of wisdom tooth pulpitis is carried out in the same way as on other teeth. In 90% of cases, the doctor performs complete removal of the pulp: only in the initial stages of chronic fibrous pulpitis is it possible to save part of the pulp. However, even if the wisdom tooth is positioned correctly and has completely erupted, very often the doctor suggests extraction rather than treatment. This is due to some features of wisdom teeth that reduce the likelihood of a successful treatment outcome.
- Location of position. Wisdom teeth are difficult to reach, and treatment of pulpitis requires almost pinpoint precision.
- Wisdom teeth have curved roots, which sometimes makes the depulpation procedure extremely difficult.
Despite the difficulty of treatment, sometimes preserving wisdom teeth is advisable. First of all, this applies to situations where, of all the molars, only “eights” remain (in the future, a prosthesis can be attached to them), as well as in the initial stages of the disease, when the chances of a successful and predictable result are higher.
Pulpitis in children
Unlike adults, children's dental pulpitis develops not due to improper oral care or caries, but due to the characteristics of milk teeth: the enamel of children's teeth is thin and poorly protected, the hard tissue of the tooth is poorly mineralized. Because of this, pulpitis occurs quite often in children.
The symptoms of childhood pulpitis do not differ from those of adults, but there are some nuances in the course of this disease: in children it is less painful; in the acute stage, there may be an increase in temperature and inflammation of the lymph nodes, the appearance of flux, and swelling of the soft tissues. Children's pulpitis is treated in the same way as adults: after examination and analysis of the clinical picture, the dentist decides how the treatment will proceed - with preservation of the pulp and nerve or not.
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