Treatment of pulpitis: When to take the whole pulp?

The article is professionally consulted by Specialist Doctor II Nguyen Khanh Nam - Doctor of Odonto-Stomatology - Department of General Surgery - Vinmec Nha Trang International General Hospital.

Inflammation of the pulp is the cause of pain when we have tooth decay. The usual treatment is to remove the pulp and seal the canal. However, not all cases of pulpitis have to do so. .

Root canal treatment (pulp treatment, also known as endodontic treatment) is the first method of intervention in cases of pulpitis.
This is a step-by-step process that aims to help clean the infected, damaged pulp inside the pulp cavity. Then, the canal containing the pulp will be cleaned, sealed and restored to the tooth. Only when doing so, will the infection be completely resolved and stop the pain for the patient.

Although when the pulp of the tooth is infected, it causes very intense pain. For cases of early caries damage, inflammatory pulp can be predicted to recover, which will provide factors to enhance the remineralization process, prevent demineralization to restore the damage instead of needing to remineralize the tooth. grab marrow.
Meanwhile, for cases that have formed a deep hole, the prognosis is that the tooth pulp is inflamed irreversibly or the pulp is necrotic, so it is necessary to remove all infected tissue, protect the pulp cavity and seal it. Hard tissue restoration with suitable materials. Only when doing so, the pulp cavity will stop the infection, the patient will no longer have pain and at the same time, still preserve the remaining tooth tissue and continue to function.
The way to recognize cases of irreversible pulpitis is that most patients will have symptoms of severe attacks, severe pain at night, which can last for hours or sometimes as short as a few minutes, The stimulation is gone, but the pain persists.
In many cases, the pain also spreads to the first half, half of the face on the same side, making the patient vaguely unable to identify the painful tooth, so it is often mistaken for the pain of other diseases.
In contrast, for cases of early caries or reversible pulpitis, there is no need to take the pulp, but only need conservative care with remineralization therapy, re-finishing the tooth surface.
In short, when to kill the marrow and take the whole marrow depends largely on the doctor's decision when examining. However, it is necessary to take care of the teeth thoroughly, and periodically check up to help detect damage early, limit the extraction of pulp, keep the integrity of the teeth and pulp, ensure the chewing function and the need to enjoy. life of each person.
BSCK II Nguyen Khanh Nam has more than 30 years of experience in Odonto-Stomatology. Doctor Nam was formerly Head of Odonto-Stomatology Department of Khanh Hoa Provincial Hospital and Deputy Director of Service Center of Khanh Hoa Provincial Hospital before being a General Internal Medicine Doctor of Medical Examination and Internal Medicine Department of Vinmec Nha Trang International General Hospital. like nowadays.