Q9: WHAT IS PULPITIS (TOOTHACHE)??

Overview
Pulpitis is an inflammation of the pulp. The pulp is a spongy soft tissue of nerves and blood
vessels encased by tooth structure. In the crown, the enamel and dentine encases the pulp.
When the integrity of the enamel and dentine is compromised eg through decay, the pulp is
exposed to irritants. This provokes a response which you feel as a toothache.
Pulpitis may be,

Reversible the pulp is able to heal if the irritation is removed eg by doing a filling
in the case of decay

Irreversible the pulp is unable to heal and requires pulp therapy or root
canal treatment

Causes
You may experience a toothache if,

there is decay

there is gum disease

there is food impacted in your gum

if your tooth has suffered trauma

there is a crack in your filling or tooth

if you have sinusitis

the roots of your molar teeth lie close to your sinus, a sinus infection could
result in these teeth being tender on biting

there is underlying pathology of your bone eg tumour or cysts

there is no identifiable cause but there is chronic, distressing pain related to a tooth
( atypical toothache)

Symptoms
When you have a toothache, you may experience any of the following. The intensity of
symptoms may vary.

pain on eating or drinking hot or cold food/drinks

dull ache at the jaw

pain which is spontaneous and throbbing

tenderness at the tooth on touching and biting

pain which may interrupt sleep

pain which may be referred to head, temple or ear

When to seek help

You should see a dentist immediately if you experience a toothache. In the meantime, the
following may ease the discomfort.

avoid hot or cold food

avoid biting on the involved tooth

take an over the counter painkiller such as paracetamol or ibuprofen

if there is an open cavity, apply a cotton soaked in oil of cloves (eugenol) into the
cavity

Treatment
Your dentist will be able to diagnose whether the pulpitis is reversibile or not. He will carry
out tests on the tooth and take radiographs. Treatment will be directed at the cause.
In the case of atypical toothache, where there is no identifiable cause, medication is the
treatment of choice. Symptoms do not subside with extraction of the tooth in atypical
toothache.

Prevention
The best way to prevent toothache is to prevent dental disease. Decay can be prevented by,

A sensible diet - limit snacking in between meals, and the consumption of refined
carbohydrates eg sweets, cake, ice cream.

Brushing your teeth with a fluoride tooth paste twice daily

Flossing at least once a day

Regular visits to the dentist for check up.