Pulp is the material that fills the hollow root canal within your tooth. Pulp contains blood and tissue cells and nerves that are what keeps the tooth and the underlying tissues healthy. Oral bacterial buildup due to improper cleanings can infect the pulp and put the tooth at risk of cavities or even extraction. The pulp infection is also called pulpitis.
In the early stages, pulpitis is usually reversible. If left untreated, pulpitis can become irreversible and severely limit the options your dentist has to treat the condition. What are the potential treatments for pulpitis?
Reversible and Irreversible: Root Canal Therapy
Root canal therapy, or RCT, is the starting point for either type of pulpitis. The procedure is designed to remove infected pulp while minimizing the risk of the infection returning inside the tooth.
RCT starts with the dentist drilling a hole into the top of your natural tooth crown to access the canal. The pulp material is then scraped out with a small tool then the canal is rinsed with an antibacterial wash. Finally, the dentist will fill the canal with a bio-cement and cap off the tooth with an artificial tooth crown.
RCT is an extremely common dental procedure and is often effective at saving the tooth from any further infections or damage.
Reversible: Apicoectomy
RCT is usually effective, but sometimes the infection can return. In the case of irreversible pulpitis, the dentist might decide to jump on to the final option of extraction, as too much damage is already done. However, reversible pulpitis can be dealt with using an apicoectomy procedure.
The regular RCT misses the pulp in the very end of the tooth roots. These ends, called the apexes, are hard to reach and typically don't hold infectious material anyway. In the rare cases where the infection is trapped in the apexes, the dentist can remove the problem by cutting the apexes off.
An apicoectomy is only slightly more involved than a regular RCT. You will have some healing time for your gums since the tissue will need to be cut to access the apexes, but the procedure is fairly straightforward and painless.
Irreversible: Extraction
If an initial RCT doesn't improve the health of a tooth with pulpitis, the condition is considered irreversible and the tooth is scheduled for extraction. While any tooth with pulpitis is considered reversible until the RCT doesn't work, the dentist can often tell when a tooth is so damaged that irreversible pulpitiis is likely.
Extraction should be followed up with a dental replacement so that you don't experience any problems or discomfort with eating or speaking.
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