How to perform pulp drainage for dental caries?

Written by Li Bao Hua
Dentistry
Updated on September 12, 2024
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Pulpotomy and drainage for caries involve a treatment method for acute pulpitis or apical periodontitis caused by infected dental nerves. Teeth are composed of enamel, dentin, cementum, and pulp tissue. The pulp tissue, also known as the dental nerve, is located within the innermost part of the tooth, surrounded by the hard layers of dentin and cementum. Therefore, once the dental nerve becomes inflamed, the pressure within the pulp chamber rapidly increases. To alleviate the pain, it is necessary to release this pressure, namely by performing a pulpotomy and drainage. This can be done by drilling to remove some of the infected dental tissues, and then opening up the pulp chamber to relieve the pressure, significantly reducing the pain. If the dental nerve is completely purulent and necrotic, the top of the pulp chamber can be removed, followed by thorough pulpotomy and drainage.

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If half of the cavity is empty, should the tooth be extracted?

Whether a tooth that is half decayed should be extracted depends on the condition of the patient's tooth root. It is recommended that the patient first undergo a dental X-ray to ascertain whether the tooth root is intact. If the tooth root is relatively sound, generally, extraction is not necessary. The decayed material in the tooth can be removed, followed by a pulp capping procedure, and then filling. Due to the severity of the decay, it is advisable to wear a porcelain crown for protection. If the decay has affected the dental pulp causing pulpitis, root canal treatment should be performed before filling the tooth and protecting it with a porcelain crown. However, if the tooth root is severely damaged, considering tooth extraction might be necessary.

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Is a cavity the same as tooth decay?

Cavities, also known as dental caries, are a chronic progressive destructive disease caused by bacterial infection of the hard tissues of the teeth. Once a tooth is affected by a cavity, it is necessary to fill the tooth as soon as possible. Otherwise, the bacteria will further infect the tooth, causing inflammation of the dental nerve. Inflammation results in significant pain, including sensitivity to hot and cold, pain intensified by temperature changes, and even symptoms of nighttime pain. The most typical symptom of pulpitis is nighttime pain, which can wake someone from sleep. Therefore, once cavities occur, it is crucial to remove the decayed part of the tooth and fill it promptly to prevent potential tooth loss.

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Is it normal to have pain after filling a cavity?

Mild pain after filling a cavity is normal. This is often seen when glass ionomer materials are used for fillings. Glass ionomer materials expand in volume within 24 hours of mixing, which can stimulate the dental nerves and cause pain. However, the pain should gradually decrease or disappear after 24 hours. If there is severe pain after the filling, it may be due to the filling material being too high or the tooth decay being too deep, reaching the dental nerves and causing nerve pain. This situation is abnormal and requires root canal treatment.

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How to brush teeth with cavities

Cavities are a disease caused by bacterial infection of the hard tissues of the teeth, belonging to a type of self-destructive and infectious disease, and cavities need to be treated in a timely manner. When brushing teeth with cavities, it is especially important to brush thoroughly. Fluoride toothpaste can be used to clean each surface of the teeth, including the occlusal, buccal, lingual, and the insides of the teeth. Sometimes it is difficult for the bristles to reach the inside of the teeth, in which case an interdental brush or dental floss can be used to clean these areas to prevent the occurrence of cavities inside the teeth. Besides brushing, it is also necessary to fill the teeth promptly, also known as dental filling.

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Can a decayed tooth be extracted?

Whether a tooth with caries can be extracted depends on the extent of the decay. If the decay is shallow, it can be treated with a one-time filling. If the decay is deep, reaching the nerve, nerve-killing treatment is required, followed by anti-inflammation measures and, after inflammation control, root canal filling. In other words, teeth should be preserved through root canal treatment whenever possible and not extracted. If the caries has reached the deep layers of the tooth dentin, or is at risk of causing a perforation, such conditions are considered non-salvageable and the tooth should be promptly extracted. After extraction, timely dental prosthetics should be placed.