What is it?
The pulp is the nerve and blood vessel tissue at the centre of the tooth. When bacteria reach it through decay, a crack or a deep restoration, the tissue becomes inflamed. Because the tooth is enclosed in hard tissue, the swelling has nowhere to expand and the pressure presses directly on the nerve.
In reversible pulpitis the pain comes only with a trigger and fades within seconds; remove the cause and the tissue recovers. In irreversible pulpitis the pain starts on its own, lasts minutes and worsens at night; at that stage the pulp no longer heals.
Signs
You will not necessarily have all of these at once.
Why does it happen?
- 01
Deep decay
The most common cause. Inflammation begins once bacteria pass through enamel and dentine and near the pulp.
- 02
A crack or fracture
Even an invisible crack opens a route for bacteria; untreated cracked tooth syndrome progresses to pulpitis.
- 03
Repeated procedures
Repeated deep restorations on the same tooth tire the pulp cumulatively.
- 04
Trauma
After a blow the pulp can die quietly months or even years later; a change in colour is often the first sign.
How does it progress?
- Stage 1
Reversible
Pain comes only with cold or sweetness and ends within seconds of the trigger being removed. Clean the decay and place a filling, and the pulp recovers.
- Stage 2
Irreversible
Pain starts unprompted, lasts minutes, worsens with heat and intensifies at night. Root canal treatment is needed.
- Stage 3
Necrosis
The pulp dies completely and the pain stops. This is not recovery; the infection moves quietly towards the root tip.
How is it treated?
In reversible pulpitis the treatment removes the cause: the decay is cleaned, a protective base is placed over the pulp where needed, and the tooth is restored. The sensitivity settles within a few weeks.
In irreversible pulpitis the pulp is removed, the canal system is cleaned and filled, and a protective restoration is placed over the tooth. The pain usually eases clearly at the first appointment.
- Pain that painkillers do not touch and that breaks your sleep
- Swelling in the face or cheek
- Fever alongside the pain
- The pain stopping suddenly
How is it prevented?
- Treat decay before it hurts; pain is a late sign that the pulp has been neared
- Have any clenching habit assessed; force produces cracks, and cracks open a route to the pulp
- Have a tooth that took a blow checked even if it does not hurt, and watch for a change in colour
Frequently asked questions
- If the pain has gone, is treatment still needed?
- Yes. Severe pain ending on its own usually means the pulp has died; the infection keeps moving towards the root tip.
- Is root canal treatment painful?
- The procedure is done under local anaesthetic. The pain comes from the inflammation that made it necessary, not from the treatment, and it usually eases at the first appointment.
This content is for general information and does not replace an in-person examination. Symptoms overlap between conditions, and a diagnosis can only be made clinically.