Pulpitis-The Leading Cause Of Toothache

Most cases of dental caries and even cavities are such that they cannot be felt, this is why a regular check up is so important, as these can be seen, identified and stopped before they reach the tooth pulp, where a condition known as pulpitis, or infection of the tooth pulp can occur, which is, as it were, the leading cause of toothache and thus, of dental emergencies. 

Before an infection reaches a nerve, it cannot be felt by the patient. The enamel and dentine is not in direct connection to the nerves, and thus an infection or cavity that only penetrates these levels will not be felt, unless accompanied with swelling. Once the dentine is breached, the nerve will become exposed, as the inside of the tooth chamber, which is filled with tooth pulp, is in direct connection with the nerves inside the mouth. This is why toothache occurs.

Aside from bacterial infections, pulpitis can come about as a result of physical trauma as well. The irritant, or infectious agent causing the toothache can be a foreign object, or a piece of one’s own tissue, such as a splinter of tooth.  

Two Kinds Of Pulpitis

Pulpitis can be differentiated into two arbitrary categories. One is reversible, and the other is irreversible. If the tooth pulp is fighting off the infection, and has not become infected entirely, and is responding to the infection or trauma. This is still painful, but tooth pulp can be saved. 

Irreversible pulpitis is when the pulp has been breached and bacteria has infected the pulp itself. The pulp may still be alive, but the damage is so severe that it will necessarily result in necrosis, or death of the tooth pulp. The outer tooth structure may still be alive, and we pronounce teeth dead only when the nerve no longer functions and they start to be discolored. 

However, dead pulp means that the nerve can become sensitive to any stimuli, and toothache will inevitably follow suit.


Reversible pulpitis can be treated with a medicated filling, topical ointment, or with a strict regimen of antibiotics. As long as the pulp is reacting to the stimulus, and is fighting off the bacteria, a little help is all that is needed. The breached area will be cleaned and sealed off, this is what is known as a filling. Sometimes, a portion of the tooth pulp also needs to be removed, as it may aid the healing process, but not to worry, the tooth pulp can regenerate itself. 

Much more complicated is the case when the pulpitis has become irreversible. In this case, a root canal treatment is inevitable, and all of the tooth pulp needs to be removed. The tooth will still need to be filled, and a medicated root filling will also need to be placed on the inside of the tooth.