Pulp necrosis: causes and treatment

Pulp necrosis is a common dental problem among the general population and one of the most frequent reasons for tooth extractionThis article describes the causes, symptoms, and steps of treatment to prevent future complications. Pulp is the center of the tooth, located under the dentin. It is made up of blood vessels, nerves, and fibrous connective tissue. If any of these more internal structures are injured or ill, it can cause pulp necrosis. This painful condition can occur after dental trauma, for example, due to a caries, periodontal disease, or failure of endodontic treatment, or as a result of systemic diseases such as diabetes mellitus or hyperthyroidism, which affect oral health.

Symptoms of pulp necrosis

Since pulp is the part of the tooth that dies in case of necrosis, the symptoms of pulp death range from mild irritation or discomfort to severe and debilitating pain. However, since symptoms are also present in other diseases of the oral cavity, it is important to know how to distinguish them. Pain is the main one that is often described as pulsating, stabbing or painful, which can be triggered by certain stimuli, such as eating certain foods, drinking cold liquids or changing temperatures. The most common symptoms of pulp necrosis are:

• Pain
• Sensitivity
• Inflammation of tissues surrounding the tooth
• Tooth discoloration
• Toothache
• Preexisting tooth pain may increase in intensity with necrosis
•  A change in the feeling of pressure when biting
• A change in appearance, such as inflammation of the gum, which can cause a change in the color of tissues surrounding the tooth
• Formation of a small abscess or swelling with pus around the tooth

Cause of pulp necrosis

There are different causes for pulp necrosisThese include caries, periodontitis, endodontic treatment failure, systemic diseases, trauma and others. Depending on the cause, prognosis and treatment are different.

• Caries: tooth decay can evolve into pulp necrosis in particularly fragile teeth, such as teeth with large fillings.
• Periodontitis: infected gums can cause bacteria to enter the root canal system, and the infection can spread to the pulp.
• Endodontic treatment failed: incomplete duct treatment can cause bacteria to enter the tooth and spread the infection to the pulp.
• Systemic diseases: disorders, such as diabetes and hyperthyroidism, can affect oral tissues and cause pulp necrosis.
• Trauma: injuries to the mouth, such as a blow to the face, can cause pulp necrosis.
• Other causes: tooth fracture, gum inflammation, a cracked tooth, and too long or too short tooth are other possible causes of pulp necrosis.

Treatment of pulp necrosis

Depending on the severity of pulp necrosis, the most common treatment options are tooth extraction or endodontics. Extraction is recommended if there are signs of infection, such as swelling and pus formation. If possible, endodontics should be chosen to save the tooth. Depending on the severity of the case, treatment may vary from antibiotics to endodontics, which carries the risk of infection and subsequent tooth loss. Endodontics is the recommended treatment for pulp necrosis. This is a procedure to remove pulp, clean the root canal and fill the tooth with a seal material. The pulp is removed and the root canal system is thoroughly cleaned under local anesthesia, which can be a sedative or oral anesthesia.

Forecast of pulp necrosis

Yes dentist is able to diagnose and treat the condition in time, the prognosis is usually positive. If the condition progresses and the blood supply is cut, necrosis occurs, and the tooth becomes increasingly sensitive and painful. If the infection is not treated, it can spread to the surrounding gums and cause inflammation. If the pulp is severely damaged, the prognosis is bad. In these cases, it is usually recommended to remove the tooth to avoid further damage to the surrounding gums and to the general health of the patient. If the pulp is partially damaged, the prognosis is better, but the tooth may continue to suffer complications, such as infections and increased sensitivity.