Dental Neuritis (Pulpitis): Causes

Pathogenesis (development of disease)

Pulpitis can be caused by numerous natural or iatrogenic (caused by medical treatment) factors.

Three main groups can be distinguished:

Infectious pulpitis, meaning the infection is caused by microorganisms such as:

  • Hematogenous (bacteria transmitted by the bloodstream).
  • Caries (most common cause)
  • Non-caries-related loss of tooth structure.
  • Periodontopathies (diseases of the periodontium).

Traumatic pulpitis

  • Infraction (cracks in the tooth)
  • Contusion, luxation (sprain)
  • Leaky restorations
  • Traumatic occlusion (e.g., pre-contacts, incorrect tooth position, grinding, temporomandibular joint disorders – CMD).
  • Dental trauma / dental injuries (crown fractures, root fractures).

Iatrogenic pulpitis (triggered by dental treatments).

  • Orthodontic treatment
  • Preparatory measures and dental prosthesis measures
  • Dental materials, which can irritate the nerve tissue.
  • Tooth preservation measures (e.g., deep fillings).

If the irritations listed above are severe enough, the dental nerve will respond with inflammation. This basically runs just like an inflammation of any other body tissue with the possible typical symptoms of redness, heating, swelling, pain and functional limitation. Due to the special location of the dental nerve and its restricted accessibility, the symptoms are specific and can be used as a clue for diagnosis.

Without adequate treatment, the disease progresses from one stage to the next. Acutely flaring inflammatory stages can be observed; however, chronicity is also possible in pulpitis.

Furthermore, pulpitides can be divided into reversible (reversible) and irreversible (no longer reversible) stages.

Etiology (causes)

Biographic causes

  • Hormonal factors – menopause (menopause in women).

Behavioral causes

  • Nutrition
    • Micronutrient deficiency (vital substances) – see Prevention with micronutrients.
  • Consumption of stimulants
    • Alcohol – damage to the natural oral flora by alcohol.
    • Tobacco (smoking) – damage to the natural oral flora due to smoking.
  • Psycho-social situation
    • Stress – bruxism (grinding at night).
  • Insufficient oral hygiene

Causes related to disease

Operations

  • Tumor operations in the head/neck area and associated damage to the teeth and soft tissues.

Medication

  • Cortisone (including steroids)
  • Hormonal contraceptives (“pill”).
  • Hormone replacement therapy (estrogens)
  • Tricyclic antidepressants