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Pulpitis (Dental Pulp Inflammation)

Pulpitis (Dental Pulp Inflammation) - What it is

Pulpitis is an inflammation of the dental pulp. The dental pulp consists of connective tissues, blood vessels and nerves. The pulp is surrounded by enamel and dentine. When the integrity of the enamel and dentine is compromised, the pulp will be exposed to irritants. This provokes a response which you may feel as a toothache. Pulpitis may be

• Reversible – the pulp is able to heal if the irritation is removed such as by doing a filling in a tooth with decay.

• Irreversible – the pulp is unable to heal and requires pulp therapy or root canal treatment. 

 Diagram of Infected Versus Inflammed Pulp Tissue by the National Dental Centre Singapore

Pulpitis (Dental Pulp Inflammation) - Symptoms

A tooth with dental pulp inflammation or infection can present with one or more of the following symptoms:

• Prolonged sensitivity to hot or cold food / drinks

• Pain that is unprovoked • Pain that is spontaneous and throbbing

• Pain on biting • Pain which may interrupt sleep

• Pain which may be referred to head, temple or ear

• Discolouration of the tooth

• Tenderness of the overlying gums

• Abscess or swelling

Sometimes, there may be no symptoms at all. When the dental pulp inflammation or infection is left untreated, it can eventually cause severe pain, abscess (swelling) and loss of the supporting bone.

It is best to consult with your dentist if you have any of the symptoms mentioned for a more accurate diagnosis and treatment.


Abscess on upper right tooth



Pulpitis (Dental Pulp Inflammation) - How to prevent?

Pulpitis (Dental Pulp Inflammation) - Causes and Risk Factors

• Caries or tooth decay is the most common cause of dental pulp inflammation and infection.tooth-decay-national-dental-cenre-singapore


Other pathways for bacterial invasion into the tooth structure and infection of the underlying dental pulp are through:

• Defective fillings or restorations


• Cracks in the tooth structure can serve as potential pathways for bacteria and noxious stimuli to irritate the dental pulp.

Cracked Tooth by the National Dental Centre Singapore

• Traumatic injuries to the face and mouth from sports or other accidents can cause teeth to fracture, loosen or even be knocked completely out of the socket (avulsion). Any damage of the tooth structure, surrounding gum or supporting bone will allow bacteria colonisation from saliva, leading to an inflamed dental pulp.



Trauma to upper front teeth


• Excessive wear of the hard outer layers (enamel and dentine) of the tooth due to parafunctional habits like grinding of teeth also make the dental pulp more vulnerable to bacterial or acidic attack.


Excesive wear on upper and lower teeth

Pulpitis (Dental Pulp Inflammation) - Diagnosis

You should see a dentist immediately if you experience a toothache. In the meantime, the following may ease the discomfort:

• Avoid hot or cold food

• Avoid biting on the involved tooth

• Take an over the counter painkiller such as paracetamol or ibuprofen

Diagnosis of the dental pulp status of your tooth is done by your dentist using clinical examination and investigations. Some of these investigations include:

• Pulp vitality tests, such as thermal tests or electric pulp tests. These are used to determine if the dental pulp is still alive.

• X-rays (radiographs) are used to determine the extent of tooth decay and surrounding bone inflammation caused by dental pulp infection.

Pulpitis (Dental Pulp Inflammation) - Treatments

Treatment is determined by the diagnosis. If the stage of dental pulp inflammation is assessed to be reversible, it can be resolved by eliminating the causative factors, such as removing the decay and restoring the tooth, to return the dental pulp to its normal healthy state. However, if the dental pulp is irreversibly damaged or infected, root canal treatment has to be carried out.

Pulpitis (Dental Pulp Inflammation) - Preparing for surgery

Pulpitis (Dental Pulp Inflammation) - Post-surgery care

Pulpitis (Dental Pulp Inflammation) - Other Information

Prevention Prevent tooth decay having a sensible diet and practising good oral hygiene:

• Limit snacking in between meals and consumption of refined carbohydrates e.g. sweets, cake, ice cream

• Brush your teeth with a fluoride tooth paste twice daily

• Floss at least once a day

Visit your dentist for regular check-ups so that decay or a defective filling can be detected and treated early before there is irreversible damage to the dental pulp.

Avoid chewing on hard objects such as ice, hard nuts or pens to prevent cracked teeth. Wear a mouth guard if you participate in contact sports to avoid dental trauma. Any activity involving speed has an increased chance of falling and the potential of getting in contact with a hard piece of equipment. A mouth guard helps to distribute the force of impact in any accident to prevent the likelihood of dental injury to the front teeth. Do not clench or grind your teeth. If you clench or grind your teeth at night, speak to your dentist about getting a night guard.
The information provided is not intended as medical advice. Terms of use. Information provided by SingHealth

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