Gangrenous pulpitis: causes, symptoms, treatment

Every trip to the dentist for most people is a real torture. Unfortunately, visits to this doctor are not part of the habit. Many postpone visiting a specialist until the toothache will not cause sleepless nights and constant irritation. One of the diseases for which the nature of discomfort in the oral cavity is chronic gangrenous pulpitis. Treatment of this pathology always requires a qualified approach. Why it arises and what symptoms are accompanied, we will tell in this article.

Features of the disease

Gangrenous pulpitis is a disease in which inflammation of soft tissues occurs. Usually, the ailment is a complication of caries. When gangrenous lesion of the tooth first changes its color, then there is an unpleasant smell from the mouth. Patients complain of aching pain, which is worse after eating. Pulpitis is most often affected by molars of the lower jaw. In 20% of cases, the disease is accompanied by changes in the apical periodontium.

Types of gangrenous pulpitis

The disease can occur suddenly and proceed as a limited lesion of the pulp. Sometimes the inflammatory process starts slowly, periodically fading and exacerbating. In this case it is a chronic form of pulpitis.

Exacerbation of the disease occurs with a decrease in the resistance of the body or difficulty in the outflow of inflammatory exudate from the dental cavity. Among the primary clinical manifestations can be noted pain syndrome of varying intensity. Its strengthening, as a rule, occurs during the taking of hot food. The cold somewhat dulls the pain.

The main causes of the disease

Gangrenous pulpitis often develops as a result of the active vital activity of the pathogenic flora that penetrates the pulp. Infection can occur during dental manipulations, when a tooth is being opened to treat caries . Another option is the penetration of bacteria through the periodontal pockets. Infection can also occur as a result of trauma, when a part of the tooth breaks off. This disease can be an independent pathology that has arisen against the background of infection (this is chronic gangrenous pulpitis), or develop as a result of exacerbation of the inflammatory process.

Clinical picture

Pathology in most cases is accompanied by increased sensitivity to thermal stimuli. Many patients note that during eating, the tooth reacts with pain syndrome. On the other hand, cold foods rarely cause such reactions. Sometimes there is a feeling of a slight tingling, which quickly passes, and the patient does not pay attention to him at all. This symptom is due to the presence of gases in the affected areas.

Any infection that appears in the mouth, violates its microflora. As a consequence, a characteristic putrefactive odor arises. If the patient is diagnosed with acute gangrenous pulpitis, he is constantly accompanied by painful discomfort. The affected area acquires a small puffiness, which is caused by the onset of the inflammatory process.

When a patient arrives at the dentist, the specialist diagnoses the typical symptoms of carious tooth lesions. First of all, this is a large cavity. In it, the decomposition products of the pulp can be preserved. The surface of the nerve endings of the tooth is often covered with a grayish coating. Symptoms of the disease are similar to many other dental pathologies. To differentiate the pulpitis, it is enough to knock on the affected tooth. In this case, the patient should feel minor discomfort. During the sounding of the tooth, the signs are diametrically opposite. The more defeat, the less pain.

Diagnosis of gangrenous pulpitis

An important stage in the diagnosis of this disease is the study of patient complaints. The patient should tell you how discomfort in the oral cavity appeared for a long time, how teeth react to warm / cold food, which was used to reduce symptoms.

After collecting a detailed medical history, the next stage of the diagnosis is the physical examination. The first thing a dentist can detect is the difference in the color of the enamel of the affected tooth from the rest. In this case, its crown can be partially or completely destroyed. Then a deep cavity is found, filled with softened dentin. It is the result of carious disease.

In the diagnosis of pathology, thermal stimuli are often used. Under their influence, the patient experiences severe pain, which gradually subsides. For a definitive confirmation of the diagnosis of "gangrenous pulpitis", the doctor may prescribe an X-ray examination.

Basic principles of therapy

Treatment of this disease is possible only by surgery, because the doctor must remove the affected tissues of the pulp. Before performing dental manipulations, the patient is given pain medications. For the treatment of gangrenous pulpitis and periodontitis, a procedure called pulpectomy is being used today. It is not recommended for patients with elevated blood pressure, hemophilia and active tuberculosis.

The operation is very simple and involves the removal of pulp. To reduce bleeding to the affected area during the treatment, special tampons are applied. After this, the dentist lays a filling material into the cavity and forms the crowns of the tooth. If for one visit to the doctor there is no possibility immediately after removal to perform sealing, a tampon moistened in a solution of calcium hydroxide is placed in the cavity .

Less known methods of treatment

To less common methods of fighting pulpitis include extirpation and devital methods. The first involves the use of arsenic paste. However, in practice it is used extremely rarely. First, the doctor exposes the pulp. Then a special paste is applied to the affected area to treat gangrenous pulpitis and periodontitis. Two days later the doctor liquidates the pulp, processes the canals and performs the filling. The devital method of treatment is used only in case of obstruction of the root canals.

Features of the disease in children

In small patients, gangrenous pulpitis can be asymptomatic, especially with unformed roots. Upon examination, the dentist immediately identifies the affected tooth. Like adults, it is different from the rest. In its cavity there may be pulp decay products. For the treatment of temporary tooth, modern specialists offer a devital amputation with subsequent mummification of the contents of the channels by resorcinol-formalin method. This method has several drawbacks. As a result of all manipulations, the color of the enamel changes, the tooth becomes more fragile. However, this treatment is quite simple in application and less jeopardizes the rudiment of the future permanent tooth.

Prognosis and prevention of disease

Is it possible to prevent gangrenous pulpitis? Treatment, performed in a high-quality and timely manner, is a guarantee of a favorable prognosis for recovery. Sometimes it depends on the patient whether the tooth will be saved and the removal procedure will be avoided. To do this, several times a year to visit the dentist and undergo preventive examinations. The sooner the doctor discovers the problem, the easier it will be to cure. In addition, you must follow the basic rules of oral hygiene. Doctors advise brushing your teeth twice a day, use a special rinse aid. Such simple preventive measures are the key to dental health.