Therapy
If there is a small local inflammation of the crown pulp (tooth marrow), an insert with a paste containing cortisone can in some cases lead to healing. If only the crown pulp is inflamed, it is removed under anesthesia as sterile as possible and the stump is kept alive by covering it with suitable medication – for example calcium hydroxide. This treatment is called vital amputation.
If the entire pulp is affected, the only remaining step is to remove the inflamed pulp. Today, vital amputation, i.e. removal of the entire pulp under anesthesia, is preferred. The killing of the pulp with arsenic has been completely abandoned.
After disinfection of the pulp cavity and the root canals, the pulp cavity is widened and provisionally closed after insertion of a disinfecting insert. If the tooth remains painless, the final restoration can be connected. In the case of gangrene, trepanation, i.e. the opening of the pulp cavity, is the first measure.
This reduces the pressure and the pain subsides. The subsequent root canal treatment is more protracted, as putrefactive bacteria have caused a more serious infection of the pulp cavity. This results in several sessions until the treatment is finally completed.
Prophylaxis
Since the inflammation of the pulp (pulpitis) is mostly due to untreated, deeper caries, early removal of the caries is the best prevention. Therefore, the dentist should be visited more often, so that the caries can be treated in its early stages. Of course, plaque removal is also a necessary preventive measure.
Summary
The pulp fills the inner cavity of the tooth and the root canals. It consists of connective tissue, blood vessels and nerve fibres. The pulp is connected to the whole organism through the opening at the tip of the root.
Inflammation of the pulp is painful and can reach different stages, from partial inflammation to complete decomposition. The therapy depends on the extent of the inflammation and ranges from local application of cortisone pastes to complete removal with subsequent root canal treatment.
