Pulpitis is painful inflammation of the tooth pulp, the innermost part of the tooth that contains the nerves and blood supply.

The most common cause of pulpitis is tooth decay, and the second most common cause is injury. Mild inflammation, if relieved, may not damage the tooth permanently. Severe inflammation may cause the pulp to die.

Symptoms and Diagnosis

Pulpitis can cause intense tooth pain. To determine if the pulp is healthy enough to save, dentists can do certain tests. For example, dentists can apply a hot or cold stimulus. If pain persists after the stimulus is removed or if pain occurs spontaneously, the pulp may not be healthy enough to save.

Dentists may also use an electric pulp tester, which indicates whether the pulp is alive but not whether it is healthy. If the person feels the small electrical charge delivered to the tooth, the pulp is alive. Sensitivity to tapping on a tooth often means that inflammation has spread to the surrounding tissues.

Treatment

The inflammation stops when the cause is treated. When pulpitis is detected early, a temporary filling containing a sedative can eliminate the pain. This filling can be left in place for 6 to 8 weeks and then replaced with a permanent filling. Often a permanent filling can be put in immediately.

When pulp damage is extensive and cannot be reversed, the only way dentists can stop the pain is by removing the pulp by root canal treatment or tooth removal (extraction).

Last full review/revision October 2008 by James T. Ubertalli, DMD