Pulpitis

Aka: Pulpitis, Reversible Pulpitis, Irreversible Pulpitis

1. See Also
   1. Dental Caries
2. Definition
   1. Inflammation of the dental pulp
3. Pathophysiology
   1. Tooth defect allows for dental pulp exposure to pathogens
   2. Predisposing defects in the tooth
      1. Dental Caries
      2. Tooth Fracture
      3. Apical foramen defect
   3. Course
      1. Initial: Tooth cavity develops
      2. Reversible Pulpitis
         1. Mild inflammation from encroaching pathogenic material
      3. Irreversible Pulpitis
         1. Pulp chamber is rigid and does not accomodate increased pressures
         2. Pressure occludes apical foramen vessels
         3. Dental pulp tissue necroses
4. Symptoms
   1. Reversible Pulpitis: Mild tooth pulp inflammation and encroachment
      1. Pain triggered by hot, cold or sweet stimuli
      2. Provoked by lying supine
   2. Irreversible Pulpitis: Progresses from Reversible Pulpitis
      1. Severe tooth pulp inflammation
      2. Pain is severe, persistent and poorly localized
      3. Pain may radiate to ear, temple, eye or neck
5. Management
   1. Reversible Pulpitis
      1. Dental Caries debris removed
      2. Dental filling applied
   2. Irreversible Pulpitis
      1. Root canal or Tooth Extraction
      2. Do not delay management more than a few days
6. Complications (of Irreversible Pulpitis)
   1. Apical Periodontitis
   2. Apical Abscess
   3. Periodontal Cellulitis
7. Prevention
   1. See Oral Health
   2. See Oral Health in Children
   3. See Dental Caries
8. References
   1. Delaney (2017) EM:Rap 17(9): 5-7