PULPITIS

PULP is an inflammation of the tooth pulp. As a rule, it arises from the penetration into the pulp of microflora from the carious cavity of the tooth with the progression of the carious process. Causes of pulpitis can be a toxic effect on the pulp of filling materials containing acrylic resins, silicate cements, etc., thermal trauma to the pulp, for example, with intensive preparation of hard tooth tissues or irrational cooling of the cutting tool, traumatizing the pulp during fracture of the crown or during deep processing of the bottom Carious cavity.

Acute pulpitis manifests itself as spontaneous pain (usually nocturnal) in the form of attacks. With focal pulpitis, short-term, interobointer intervals are long; Probing the carious cavity causes pain in one point, the percussion of the tooth is painless. The spread of inflammation to the root pulp (diffuse process) leads to increased pain, prolonged seizures. With diffuse serous pulpitis, the patient does not always correctly point to the affected tooth, probing the bottom of the carious cavity and the percussion of the tooth are painful, the pain reaction to the cold is sharply pronounced. With purulent inflammation, pain increases, pulsates, irradiates along the branches of the trigeminal nerve; Percussion of the tooth is painful.

Chronic pulpitis can develop primarily or be the outcome of acute pulpitis. It is usually observed in milk teeth or teeth, repeatedly treated for caries and having several carious cavities. The process is characterized by the destruction of pulp varying degrees. For chronic pulpitis without exacerbation, spontaneous pain is not characteristic. With fibrous pulpitis, pain is caused by mechanical, chemical and temperature stimuli, can occur with sudden temperature changes; Probing the bottom of a carious cavity is painful. With proliferative pulpitis, the cavity of the tooth is opened, the pain and bleeding of the pulp are observed when food enters the carious cavity; Percussion of the tooth can be painful. With gangrenous pulpitis there is a feeling of raspiraniya in the tooth, rarely there are short-term pains, usually from hot food; The open cavity of the tooth contains a dirty gray, usually malodorous mass. With the action of thermal or mechanical stimuli, chronic pulpitis can become aggravated, which is accompanied by the occurrence of spontaneous pain. Pulpitis can be complicated by periodontitis.

Emergency care for acute pulpitis includes treatment of the bottom of the carious cavity with solutions of anesthetics (novocaine, dicaine) and steroid hormones; With purulent pulpitis, in addition, - open the cavity of the tooth. Conservative treatment is aimed at preserving and restoring the vital activity of the pulp. It is shown only to young people with acute focal pulpitis and is ineffective in late referral to a doctor. Surgical treatment involves the removal of the entire pulp or its coronal part.

Prevention consists in the prevention and timely treatment of dental caries, the accurate processing of hard tooth tissues during their treatment, the use of non-toxic filling materials. Patients with pulpitis, especially after conservative treatment, should regularly visit the dentist.