How to determine dental nerve necrosis

As we age, our teeth also age. When the dental nerve dies, our teeth will fall out. At this time, our gums will not feel any pain and dentures can be installed. So, what causes dental nerve necrosis? Let’s take a look at it today, and we hope that everyone can take precautions in their lives.

Whether the dental nerve is necrotic can be determined by stimulating the dental nerve to see if pain occurs. Causes of pulp necrosis include:

1. Microbial infection

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

Bacterial infections occur through:

(1) Infection through tooth defects, such as deep caries, dental trauma, severe wear and other serious tooth defects. Bacteria and toxins invade the pulp through the dentinal tubules or pulp penetration points.

(2) Through periodontal infection, bacteria and toxins pass through the periodontal pocket, through the apical foramen, and the lateral root canal and invade the dental pulp.

(3) Blood-borne infection: It is very rare for bacteria and toxins to invade the dental pulp through the blood, but it is not impossible.

2. Chemical stimulation

(1) Drug stimulation

Disinfection drugs after cavity making, such as phenols, may irritate the pulp.

(2) Filler stimulation

Directly padding deep cavities with zinc phosphate cement or directly filling with composite resin may irritate the gaps between teeth.

3. Physical stimulation

(1) Temperature stimulation

If a gas turbine is used when making a hole, water must be sprayed to cool it down, otherwise it will cause congestion and bleeding of the pulp and cause inflammation.

(2) Current stimulation

If two restorations made of different metals are in contact in the oral cavity, a potential difference can be generated through saliva, which can cause certain stimulation to the dental pulp.

(3) Impact of air pressure changes

Changes in air pressure while flying in an airplane at high altitude or diving in deep water can cause an acute attack of pulp disease.

Dental pulp necrosis usually requires preventive work. Measures to prevent dental 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.

Common clinical symptoms of pulp necrosis are as follows:

1. The affected teeth generally have no subjective symptoms.

2. The crown may have deep caries or other hard tissue diseases of the tooth, or may have fillings, deep periodontal pockets, etc.

3. The crown of the tooth changes color, becoming dark yellow or gray and losing its luster.

4. No response to pulp vitality test.

5. X-rays showed no obvious abnormalities in the periapical images of the affected teeth.

6. Due to the special anatomical structure of teeth, once the pulp is diseased (such as inflammation), it is irreversible. In other words, once the dental pulp is diseased, it will inevitably lead to pulp necrosis.