Every trip to the dentist is a real torture for most people. Unfortunately, visits to this doctor are not a habit. Many put off visiting a dentist until a toothache causes 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 occurs and what symptoms it accompanies, we will tell in this article.
Features of the disease
Gangrenous pulpitis is a disease in which inflammation of the soft tissues occurs. Usually the disease is a complication of caries. With a gangrenous lesion of the tooth, its color first changes, then an unpleasant odor from the oral cavity appears. Patients complain of aching pain that gets worse after eating. Pulpitis most often affects the 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 in the form of a limited lesion of the pulp. Sometimes the inflammatory process is born slowly, periodically fading and aggravating. In this case, we are talking about the chronic form of pulpitis.
Exacerbation of the disease occurs when the body's resistance decreases or the outflow of inflammatory exudate from the dental cavity becomes difficult. Among the primary clinical manifestations, pain syndrome of varying intensity can be noted. Its amplification, as a rule, occurs during the adoption of hot food. The cold dulls the pain somewhat.
Main causes of disease
Gangrenous pulpitis most often develops as a result of the active life of pathogenic flora that penetrates into the pulp area. Infection can occur during dental procedures, when a tooth is opened for caries treatment. Another option is the penetration of bacteria through periodontal pockets. Infection can also occur as a result of trauma, when part of the tooth breaks off. This disease can be an independent pathology that has arisen against the background of an infection (this is chronic gangrenous pulpitis), or develop as a result of an 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 reactspain syndrome. On the other hand, cold foods rarely cause these reactions. Sometimes there is a feeling of slight tingling, which quickly passes, and the patient does not pay attention to it at all. This symptom is due to the presence of gases in the affected areas.
Any infection that appears in the oral cavity disrupts its microflora. As a result, there is a characteristic putrid smell. If a patient is diagnosed with acute gangrenous pulpitis, he is constantly accompanied by pain discomfort. The affected area acquires a slight swelling, which is due to the onset of the inflammatory process.
When a patient gets to see a dentist, a specialist diagnoses the typical symptoms of a carious tooth lesion. First of all, it is a large cavity. It may contain decay products of the pulp. The surface of the nerve endings of the tooth is most often covered with a grayish coating. Symptoms of the disease are similar to many other dental pathologies. To differentiate pulpitis, it is enough to knock on the affected tooth. In this case, the patient should feel slight discomfort. During the probing of the tooth, the signs are diametrically opposed. The bigger the lesion, the less pain.
Diagnosis of gangrenous pulpitis
An important step in the diagnosis of this disease is the study of patient complaints. The patient should tell how long the discomfort in the oral cavity appeared, how the teeth react to warm / cold food, what he used to reduce symptoms.
After collecting a detailed anamnesis, the next stage of diagnosis comes - a physical examination. The first thing that 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 filled with softened dentin is found. It is the result of a carious disease.
In the diagnosis of pathology, thermal stimuli are often used. Under their influence, the patient experiences severe pain, which gradually subsides. To finally confirm the diagnosis of gangrenous pulpitis, the doctor may prescribe an X-ray examination.
Basic Principles of Therapy
Treatment of this disease is possible only with a surgical method, since the doctor must remove the affected pulp tissue. Before performing dental procedures, the patient is given painkillers. For the treatment of gangrenous pulpitis and periodontitis, a procedure called pulpectomy is used today. It is not recommended for patients with high blood pressure, hemophilia and active tuberculosis.
The operation is very simple and involves the removal of the pulp. To reduce bleeding, special tampons are applied to the affected area during treatment. After that, the dentist puts filling material into the cavity and forms the crowns of the tooth. If in one visit to the doctor it is not possible to perform a filling immediately after removal, a swab dipped incalcium hydroxide solution.
Less known treatments
The less common methods of dealing with pulpitis include extirpation and devital methods. The first involves the use of arsenic paste. However, it is rarely used in practice. First, the doctor exposes the pulp. Then a special paste is applied to the affected area for the treatment of gangrenous pulpitis and periodontitis. Two days later, the doctor eliminates the pulp, processes the canals and performs a filling. The devital method of treatment is used only in case of root canal obstruction.
Features of the disease in children
In young patients, gangrenous pulpitis may be asymptomatic, especially with immature roots. On examination, the dentist immediately identifies the affected tooth. Like adults, it differs in color from the rest. In its cavity may be decay products of the pulp. For the treatment of a temporary tooth, modern specialists offer devital amputation followed by mummification of the contents of the canals by the resorcinol-formalin method. This method has several disadvantages. As a result of all manipulations, the color of the enamel changes, the tooth becomes more fragile. However, this treatment is quite simple to use and puts less risk of injury to the bud of the future permanent tooth.
Prognosis and prevention of the disease
Can gangrenous pulpitis be prevented? Treatment,performed qualitatively and in a timely manner, is a guarantee of a favorable prognosis for recovery. Sometimes it depends on the patient himself whether it is possible to save the tooth and avoid the extraction procedure. To do this, you need to visit the dentist several times a year and undergo preventive examinations. The sooner a doctor detects a problem, the easier it will be to treat. In addition, it is necessary to observe the elementary rules of oral hygiene. Doctors advise brushing your teeth twice a day, using a special rinse. Such simple preventive measures are the key to dental he alth.
