Pulpitis

Pulpitis is an inflammation of the pulp of the tooth, which is manifested by attacks of pain.

Etiology. The microflora of the carious cavity, chemical, mechanical and thermal injuries. Pathogenesis is associated with the progression of the carious process and an inflammatory response to the microflora and a trauma to the pulp. Infection is possible through the apical foramen, for example, with periodontal disease.

Symptoms, course. Spontaneous paroxysmal pain, especially at night, provoked by mechanical, chemical and temperature stimuli. Characterized by the irradiation of pain along the course of the corresponding branch of the trigeminal nerve.

With serous forms at the beginning of the disease, attacks of pain, usually aching, are infrequent and short-lived, as the process progresses, they become more frequent and lengthen. With purulent pulpitis, attacks are prolonged, pulsating pains increase. With serous pulpitis, cold causes a painful attack, and with purulent - it stops. In chronic forms of pulpitis, typical pain attacks occur mainly during exacerbation. The diagnosis is made on the basis of characteristic complaints, revealing the carious cavity and probing its bottom. With purulent and chronic forms percussion is usually painful.

The treatment is aimed at arresting the inflammatory process and the pain attack. In serous forms, pulp can be preserved in young people: excision of the affected dentin, medicamentous (antibiotics, calcium hydroxide, etc.) treatment and sealing. Surgical treatment involves the removal of all or only coronal pulp under conductive anesthesia or after devitalization (arsenious acid, paraform). Emergency care for acute serous forms: cleaning the carious cavity of softened dentin (excavator) and its irrigation with a warm solution of anesthetic (2% solution of novocaine, dicaine, 5% cocaine solution) or introduction into the carious cavity of a tampon impregnated with a solution of steroid preparations (prednisone, prednisolone ). In case of acute purulent pulpitis, it is necessary to open the cavity of the tooth. Inside prescribe analgin, amidopirin.

Forecast. In the absence of treatment, pulp necrosis and the spread of the process to the peri-vertebral tissues. In treatment, as a rule, the outcome is favorable. Prevention - timely treatment of caries.