Pulpitis is where the living part of your tooth aka the dental pulp becomes inflammed.
The dental pulp is made up of blood vessels and nerves and is responsible for nourishing the hard parts of the tooth. Yes, our teeth are actually alive. This means that they respond to any kind of trauma or insult such as dental caries, being prepared for a crown or just sensitivity to cold things.
Our teeth can respond in a number of ways- by retreating away from the problem, by laying down more dentine to create more of a barrier, or by sending more natural defence to the area. We do this last part by opening up our blood vessels, a process known as, you guessed it, 'inflammation'.
Unlike the rest of our bodies, where this inflammation has room to spread and expand, there is not a lot of space inside a little tooth. As a result we experience pain as the pressure builds up, pushing on the nerves inside.
We can divide pulpitis into two categories, which help us decide on the most appropriate treatment:
- Reversible Pulpitis. This is a mild inflammation of the pulp, that with appropriate treatment will settle down and return to normal.
- Irreversible Pulpitis. This is a severe inflammation from which the pulp is unlikely to recover. The swelling inside the tooth is so great that it essentially strangles itself, cutting off its own blood supply. The tooth is likely to die and therefore will require either a root canal treatment or an extraction.
In reality, inflammation of the pulp is a spectrum of changes and we need to appreciate this when interpreting the symptoms, it is not always cut and dry. The classic symptoms of each are discussed below.
If left untreated (i.e. the problem isn't removed) reversible pulpitis is likely to progress to irreversible pulpitis given time. Certainly if dental decay is responsible and you don't get a filling, this will almost certainly be the case.
You can see why it makes sense to see a dentist sooner rather than later if you get any symptoms, that is unless you would rather have a root canal treatment than a filling.