How to deal with the pain from molar pulpitis?

Written by Li Bao Hua
Dentistry
Updated on September 15, 2024
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Pulpitis in molars can be painful and requires dental treatment. During the treatment of pulpitis, the first step is to use a drill to remove the infected dentin and bone. If the dental nerve is exposed and the inflammation of the pulp is severe, a nerve-killing treatment can be conducted. In cases of acute inflammation, it is necessary to first open up the tooth. Once the inflammation subsides, nerve-killing treatment can proceed. Otherwise, the pressure is too great and the pain may intensify. If the pain is unbearable during the drilling process in the treatment of pulpitis, local anesthesia can be administered to the tooth. Once the anesthesia takes effect, the pain will be significantly less during the drilling stage.

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Written by Li Bao Hua
Dentistry
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What is pulpitis?

Pulpitis is also an inflammatory reaction occurring in the pulp tissue, caused by the further infection of bacteria when tooth decay is not timely halted, and it represents the natural conclusion of tooth decay. The dental tissues are divided into enamel, dentin, cementum, and pulp tissue, with the pulp tissue located on the innermost side, which is commonly referred to as the dental nerve. If the bacterial infection is not promptly halted in the early stages within the hard tissues of the tooth, that is, if the tooth is not filled in time, the bacteria then further infect the innermost pulp tissue, causing inflammation of the pulp tissue, which is clinically referred to as pulpitis. Pulpitis involves severe pain, necessitating prompt root canal treatment for the tooth.

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Written by Li Bao Hua
Dentistry
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Will pulpitis cause the gums to swell?

Pulpitis rarely causes gum swelling; it is generally inflammation at the apex of the tooth root that leads to it, or gingivitis causing swollen gums. Pulpitis is a bacterial infection of the tooth's hard tissues. If not treated promptly and the progression of the decay is not halted in time, it can infect the tooth nerve and cause pulpitis. At this stage, the bacterial infection is confined to the pulp tissue, which is the interior of the tooth. The gums are the supporting tissues of the teeth. If pulpitis is not treated promptly and the inflammation further progresses to the root apex area, and if the inflammation in the root apex area cannot be effectively drained, it will lead to pus discharge outward to the mucosa or skin, forming swollen gums, or a gum abscess, or swelling around the teeth due to food residue remaining after eating. Therefore, pulpitis generally does not cause swollen gums.

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Written by Li Bao Hua
Dentistry
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Does pulpitis make it painful to tap the tooth?

Pulpitis does not necessarily cause pain when the tooth is tapped. When we talk about pain from tapping a tooth, it mainly refers to examining pain in the apical area. If tapping the tooth causes pain, it indicates that the inflammation has gathered at the root tip, manifesting as what is clinically described as tenderness upon percussion. Pulpitis may simply be a bacterial infection of the dental nerve, localized around the nerve or confined within the roots, where the nerve is infected but the apical nerve remains intact. In such cases, tapping the tooth would not cause pain. This means that in the early stages of pulpitis, there might not be tenderness upon percussion, but spontaneous pain from the dental nerve or pain triggered by temperature changes might still occur.

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Written by Li Bao Hua
Dentistry
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What should I pay attention to with pulpitis?

Pulpitis is an inflammation of the dental nerve caused by bacterial infection, and there are certain dietary considerations with pulpitis. When pulpitis occurs, it can sometimes trigger pain sensitive to cold, heat, acid, and sweetness, so consuming foods that are cold, hot, sour, or sweet can sometimes cause severe tooth pain. When pulpitis reaches the stage of suppuration, there is pain alleviated by cold and exacerbated by heat. It is common to see people holding cold water in their mouth or bringing a water bottle to the clinic, indicating that at the stage of suppuration, cold water can relieve pain, but hot water can worsen it. When pulpitis occurs, it can sometimes also cause earaches or headaches. It is important to note that it can sometimes resemble trigeminal neuralgia and needs differentiation. If the pain is caused by trigeminal neuralgia, treating the teeth alone will not alleviate the pain.

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Otolaryngology
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How is pulpitis treated?

Pulpitis is an emergency in dentistry, and different types of pulpitis require different treatment methods. The first step in treating pulpitis is to administer anesthesia, and if time allows, root canal treatment should be completed in one session. Root canal treatment involves removing and cleaning the dental nerve inside the root canal in one go, then using dental cement and paste to fill the root canal, thereby inhibiting bacterial growth and reproduction. Generally, three to four root canal treatments are needed. Medication treatments include cephalosporins, erythromycin, and pain relievers to alleviate pain. Additionally, tooth extraction may be advised for severe inflammation and poor dental condition.