What should I do if my tooth is rotten to the pulp

There are many types of dental diseases, the most common of which are crooked teeth or changes in tooth color. Among all dental diseases, pulp necrosis is the most serious one. If the dental pulp is necrotic, people's teeth will be damaged on a large scale. In severe cases, all teeth may need to be extracted and replaced. However, this treatment method is very complicated and very harmful to the health of human teeth. So, what should you do if your tooth is rotten to the pulp?

1. Consequences of pulp necrosis

Every serious illness is initially transformed from a milder disease, just like pulp necrosis is transformed from various types of pulpitis. Therefore, any health problems should be treated promptly. The consequence of pulp necrosis may be that the entire tooth has to be extracted and a dental implant is required to restore normal use. It must be discovered early and treated early.

1. Acute pulpitis: Most of the symptoms are paroxysmal severe pain, especially at night. If it is purulent pulpitis, the pain will be aggravated by heat stimulation, and cold water in the mouth can relieve the pain. Patients often cannot locate the pain, and the pain radiates to half of the face.

2. Chronic pulpitis: There are recurrent spontaneous pains in the affected teeth, which are mostly caused by caries. It manifests as dull pain or biting pain, and often causes pain when encountering temperature stimulation or food stuck in the cavity.

Pulp necrosis may be caused by trauma or by chemical irritation from restorative materials such as silicone cement and composite resin. Clinical manifestations are mostly without pain symptoms, with a history of pulpitis, trauma, and orthodontics; the teeth become dark yellow or gray and dull; there is no reaction to cold, hot, and electric diagnosis; deep caries, fillings, other hard tissue diseases of the tooth, or deep periodontal pockets may be found, and there is no reaction to probing the pulp foramen.

2. Causes of Pulp Necrosis

Microbial infection: Bacteria are the most important pathogenic factors of pulp disease. The bacteria are mainly facultative anaerobes and obligate anaerobic bacilli, such as streptococci, actinomycetes, lactobacilli, etc.

The stimulation of chemical drugs, such as phenol when disinfecting tooth decay cavities, may damage the pulp tissue because of its strong penetrating power. For example, when silver nitrate is used to disinfect tooth cavities, if the doctor uses it improperly, it can damage the pulp tissue and cause pulp necrosis.

Trauma to the teeth can also lead to pulp necrosis. When a tooth is injured, it affects the tissues in the apical area, which can cause embolism in the tissues in the apical area and the root canal, leading to pulp necrosis.

The materials needed to repair decayed teeth contain free substances. The free acids will stimulate the pulp and cause pulp necrosis. Teeth filled with silicate cement will initially have obvious infiltration of odontocytes, which will cause disorder in the odontoblast cell layer. After five to eight weeks, the dental pulp will become moderately or severely inflamed, and there will be abscesses, which will cause great irritation to the dental pulp.

3. What are the clinical manifestations of pulpitis?

1 Symptoms

The main symptom of acute pulpitis is severe pain, the nature of the pain has the following characteristics:

(1) Spontaneous paroxysmal pain: sudden and severe spontaneous sharp pain without any external stimulation. Pain can be divided into persistent and remission processes. In the early stages, pain lasts shorter and relief lasts longer. In the late stage of inflammation, the pain lasts longer, while the relief time is shortened or there is no pain interval at all.

(2) Night pain: The pain often occurs at night, or the pain at night is more severe than during the day. Patients often have difficulty falling asleep due to pain, or wake up in pain during sleep.

(3) Temperature stimulation aggravates pain: Hot and cold stimulation can induce severe pain in the affected tooth. In the early stages, they are more sensitive to cold stimuli. When the pulp becomes suppurated or partially necrotic, "heat causes pain and cold relieves pain". This is why patients often come to see the doctor with ice packs on their faces.

(4) The pain cannot be localized by the patient: When the pain occurs, the patient is often unable to accurately point out the tooth position, and the pain is radiating or referred. But this pain does not occur in the area opposite to the ringyard.

2. Inspection

(1) The affected tooth may be found to have deep caries or other hard tissue diseases very close to the pulp cavity, or there may be fillings on the crown or deep periodontal pockets.

(2) Probing often causes severe pain, and sometimes tiny perforations can be detected.

(3) During temperature testing, the affected teeth react extremely sensitively. The pain may persist for some time after the stimulus is removed. When conducting a pulp vitality test, the affected tooth will have increased reactivity in the early inflammation stage, while it will be sluggish in the late inflammation stage.

(4) Teeth in late-stage inflammation may experience mild vertical percussion pain.

4. Measures to prevent pulp necrosis

1. Pay attention to oral hygiene

From the perspective of the causes of pulp disease, the incidence rate is higher in rural areas, and unclean oral cavity is the main cause. People who pay attention to oral hygiene and protect themselves well can suffer from fewer or no diseases. Even if they become ill, early treatment can achieve better and stable results. Therefore, strengthening health publicity and education, striving to improve people's oral hygiene habits, and carrying out popular treatment for unclean gingivitis can all play a preventive role.

(ii) Avoid foreign body damage

Many periodontal diseases are caused by long-term food impaction, trauma and other reasons, which should attract the attention of patients and dentists and be corrected in time. In particular, periodontal disease caused by poor quality work should be avoided. For example, the filling or restoration is too high, causing trauma, poor contact points causing food impaction, and instruments damaging the epithelial attachment at the bottom of the gingival sulcus during cleaning, resulting in the formation of periodontal pockets.

3. Early detection and early treatment

Satisfactory treatment results can be achieved for early-stage periodontal disease after irritants such as tartar are removed and inflammation subsides. The effect of late treatment is very poor, so oral disease surveys should be conducted regularly to facilitate early detection and treatment.