pulpitis

Pulpitis is an inflammation of the dental pulp, the soft tissue inside a tooth that contains nerves and blood vessels. It results from irritation such as dental caries, trauma, deep restorative procedures, cracks, or repeated chemical or thermal insults.

Two main forms are recognized: reversible pulpitis, in which the pulp can recover after removing the irritant, and irreversible pulpitis, in which inflammation persists and pulp function is compromised, often progressing to pulp necrosis if untreated.

Symptoms of reversible pulpitis include sharp pain to cold or sweet stimuli that subsides after removal, with no spontaneous pain. Irreversible pulpitis typically presents as spontaneous or lingering toothache, prolonged sensitivity to heat or cold, and may be difficult to localize.

Diagnosis is clinical and may include cold or thermal sensibility tests, electric pulp testing, percussion or palpation, and radiographs to assess periapical status. Dentin hypersensitivity and other facial pain etiologies are considered in the differential diagnosis. Test results must be interpreted with clinical findings and vitality status.

Treatment aims to relieve pain and preserve pulp vitality when possible. Reversible pulpitis is managed by removing the irritant and sealing the tooth. Irreversible pulpitis commonly requires endodontic treatment (root canal therapy) or extraction; in selected young patients with deep caries, partial pulpotomy or pulpotomy may preserve vitality.

Prognosis is generally favorable when treated appropriately. Prevention focuses on reducing caries and trauma risk through good oral hygiene, fluoride exposure, protective restorations, and prompt management of caries and cracks.