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Conditions

Dentistry · Oral health

Pulpitis and apical periodontitis

Understand inflammation of the dental pulp and tissues around the root tip.

Editorial publication · Medical review pending.

Understand

Pulpitis affects living pulp inside a tooth; apical periodontitis affects tissues around the root tip, often after pulpal infection or necrosis.

Possible symptoms

Lingering sensitivity, spontaneous or night pain, pain on biting or tapping may occur, although a chronic lesion can be silent.

Causes and associated factors

Deep decay, a crack, trauma, a leaking restoration or repeated dental procedures can irritate or infect the pulp.

Diagnosis

Diagnosis identifies the pulpal and apical status; the apparent location of dental pain can be misleading.

Tests

Cold or electric pulp tests, percussion, palpation, probing and X-rays are interpreted together and compared with nearby teeth.

Course of the condition

Reversible inflammation may heal after the cause is treated; irreversible damage or necrosis can progress to infection and abscess.

Care options

Depending on diagnosis, protection and restoration, vital-pulp treatment, root canal treatment, retreatment, endodontic surgery or extraction may be discussed.

When to consult

Seek prompt care for persistent, spontaneous, night-time or biting pain, even if it later disappears.

Urgent help

Swelling, fever, feeling very unwell, or difficulty opening the mouth, swallowing or breathing needs urgent dental or medical care.

Questions for your doctor

  • What exact diagnosis explains my symptoms?
  • Are the tooth, gum, bone or jaw joint affected?
  • Which options can preserve natural tissues?
  • Which benefits, limits, risks and costs should I compare?
  • What follow-up and warning signs should I plan for?

Continue reading

A procedure linked to a condition does not establish an indication for your individual situation.

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