What is the purpose of dental pulp drainage? Why does it still hurt after doing it?

Toothache is not a life-threatening disease. People who have experienced toothache understand the feeling. For patients who cannot bear toothache, pulp drainage will be performed to relieve the pain. Although open pulp drainage can reduce pain, it cannot completely eliminate inflammation. Generally, there will still be pain at this time. When the inflammation is completely eliminated and the activating agent is inserted, the pain will also disappear. As a patient, you don’t need to worry too much about the treatment reaction, which is generally a normal phenomenon.

Here are the steps and timelines for my root canal treatment:

1. Open the pulp and keep it open for 2 days with cotton wool.

2 Place a devitalizing agent (drug that kills the tooth nerve) and seal it for one week.

Prepare 3 root tubes and seal them with camphor phenol cotton balls for one week.

4. The root canal filling can only be done when the tooth is no longer painful.

The mechanism of pain in acute pulpitis can be divided into two aspects: exogenous and endogenous. In acute pulpitis, due to increased vascular permeability, plasma proteins and neutrophils in the blood vessels infiltrate into the tissues, causing local swelling, which mechanically compresses the nerve fibers there and causes pain. This is the exogenous factor that causes pain. On the other hand, various chemical mediators in the exudate, such as 5-hydroxytryptamine, histamine, bradykinin and prostaglandins, can be detected in the inflamed pulp.

These inflammatory mediators are endogenous factors that cause pain. It is reported that the concentration of inflammatory mediators in the pulp of patients with pulpitis symptoms is higher than that in the pulp of asymptomatic patients.

In case of acute pulpitis, pulpotomy and drainage can reduce the pressure in the pulp cavity and relieve pain, but it cannot completely remove inflammatory mediators. In addition, due to physical stimulation during pulpotomy and contamination of pulp tissue after opening the pulp cavity, it is normal for some patients to have increased pain after surgery. There is a recovery period and the pain will go away after the inflammation is eliminated. If you have root canal treatment, your attending physician will tell you when to go for a follow-up visit.