Toothaches are a dread occurrence for anyone, but they can be especially troublesome to children who often have a limited tolerance for pain. There are numerous causes of toothaches in children, and one of the most common is a condition known as pulpitis. This sometimes-excruciating condition can be difficult to diagnose and treat, but a qualified pediatric dentist can provide children with much-needed relief. Below is more information about pulpitis in children, its causes, diagnosis and treatment.
Human teeth are similar to an onion in that they are layered: the enamel, dentin and pulp, in order, comprise three layers from outside to inside. The innermost layer, the pulp, consists of tissues that both provide nourishment for the tooth as well as serve as a conduit for nerves and blood vessels. If the pulp swells, the resulting condition is known as pulpitis.
Pulpitis can be mildly painful or even completely painless in some instances, but it is just as likely to cause agonizing pain for the sufferer. Due to the fact that it is both within highly innervated tissue and also within a confined space, this swelling is usually acutely painful and only compounds as it increases.
Causes of pulpitis
Pulpitis is caused by one of several things; tooth decay that penetrates the enamel, dentin and attacks the pulp itself is the most common cause. For children who are susceptible to tooth decay, this means pulpitis is an ever-present threat if decay it isn't caught and treated in time. That makes regular dental checkups an essential item for children so pulpitis doesn't become difficult to treat.
Another cause of pulpitis is trauma to the teeth. This can include significant trauma such as blows to the teeth by objects, falls or other childhood accidents. In some of these cases, pulpitis might not make an appearance right away after such an accident, but it may develop slowly instead. Even non-injurious trauma can cause pulpitis. Repetitive chewing on foreign objects or teeth grinding can cause deep-seated irritation within the pulp. Eating hard candy or other foods can also be a catalyst for pulpitis, especially if it is carried out to an excessive degree.
A final cause is injury sustained by ill-advised dental treatments. Repeated fillings or other treatments that manipulate and jar the teeth can be a cause of pulpitis. It is important that parents find a pediatric dentist who is able to understand the need to prevent pulpitis by using age-appropriate techniques and approved treatments.
Diagnosis of pulpitis
Pulpitis isn't always easy to diagnose, especially if a child has trouble articulating the source of their pain. Special testing that measures tooth sensitivity can be performed by a pediatric dentist, and that often pinpoints the troublesome tooth or teeth.
Testing is also important because it can determine the severity of the pulpitis and whether it is reversible or irreversible. Reversible pulpitis is treatable, as it usually involves a non-invasive cause such as trauma. Testing reveals pulpitis to be reversible when the sensitivity fades shortly after a stimulus is applied. However, sensitivity and pain from irreversible pulpitis will linger for some time after the testing is completed. Irreversible pulpitis occurs when the cause, such as tooth decay, has penetrated into the pulp and caused advanced decay within the tooth.
Treatment of pulpitis
For children, it is particularly important for the dentist to properly assess and treat pulpitis. If a misdiagnosis is made, pulpitis can advance and become irreversible, and children can go through needless pain all the while.
When pulpitis is reversible, the good news is that treatment often involves nothing more than taking a few precautions such as avoiding hard foods and eliminating behaviors that can cause it. For tooth decay that hasn't progressed too far, dentists use therapeutic interventions that kill harmful bacteria affecting the pulp.
In the case of irreversible pulpitis, the approach used by many dentists is to remove the diseased tissue and replace it with a neutral filler in order to stabilize it. That leaves the tooth "dead", but a properly-stabilized dead tooth can still be useful for eating and for cosmetic reasons. Just as important for children, primary teeth serve to keep teeth aligned and prevent gaps from forming at a later date. Pediatric dentists may recommend that a dead primary tooth be left in place to keep the status quo from being interrupted. When the secondary tooth erupts, it will be provided with the space it needs as a result.