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Root canal treatment

Root canal treatment

Endodontic treatment is necessary when microorganisms and their toxins enter the root canals, infecting the nerve and pulp of the tooth.

Specialist

Indrė Bružaitė
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Indrė Bružaitė

Dentist

Causes of pulpitis
How to recognise pulpitis?
Reversible pulpitis

Causes of pulpitis

The pulp is a component of the tooth – a small mass of blood vessels, nerves and lymphatic vessels located inside the tooth under the enamel and the dentin. It supplies nutrients to the hard dental tissues. Teeth are alive, which means they can be traumatised, damaged by caries, or become sensitive to cold, heat, or mechanical or chemical stimuli.

When treating pulpitis, we remove the carious tissues and damaged pulp (usually), perform chemical and mechanical preparation of the root canal system, and then fill them.

Main causes of pulpitis:
  • Tooth decay (caries) that is left untreated for a long time and advances to the deeper layers of the tooth.
  • Multiple dental procedures on a single tooth, with large fillings being replaced more than once.
  • Constant tooth trauma due to a heavy bite, teeth grinding and so on.
  • Tooth trauma that causes problems with lymph and blood circulation to the tooth nerve.

How to recognise pulpitis?

The main symptom of pulpitis is pain. Unlike other parts of our body, which have room for inflammation to spread, the tooth cavity is cramped. So when the soft dental tissues get swollen, the tooth’s nerve gets compressed, and as a result, we begin to feel pain. We can only diagnose this disease during a dental examination. Pulpitis is usually confirmed through vitality testing (sensitivity to heat and cold, electrometric testing). Sometimes an X-ray is needed.

Reversible pulpitis

Reversible pulpitis is a minor inflammation of the pulp; once it heals, the soft dental tissues remain healthy. If you feel a short, sharp pain while eating or drinking something cold or sweet, you may have reversible pulpitis. This is transient pain that only lasts as long as the food or drink is in contact with your teeth, and goes away a couple of seconds after the irritant is removed.

Causes of reversible pulpitis:
  • The roots of the teeth have become exposed due to gingival recession, improper brushing or periodontitis.
  • The tooth fractured at the dentine border but did not reach the pulp.
  • The tooth crack reached the pulp.

With reversible pulpitis, we can preserve the vitality of the tooth through treatment. We usually remove the dental tissues that have been damaged by caries and then fill it, leaving it for observation. If you feel intense pain (usually at night) after reversible pulpitis treatment and your teeth feel “lifted” when you bite down, then you may need root canal (endodontic) treatment.
The longer you feel the pain, the more severe the inflammatory process inside the tooth becomes. Unfortunately, the symptoms that we observe in pulpitis can vary greatly. In addition, pain is a very subjective experience. This means that it is difficult to determine exactly what is happening inside the tooth, and sometimes the clinical situation is very close to irreversible pulpitis.

Sometimes people do not notice the symptoms of reversible pulpitis and only become concerned when the tooth begins to hurt. It is therefore important to visit the dentist regularly (even if your teeth do not hurt), because we can detect the first possible signs of inflammation of the tooth nerve during the examination or in preventive x-rays.

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