Pulpitis: Symptoms and Treatment

If you have tooth pain while drinking a hot or cold drink, you may be experiencing pulpitis, also known as a toothache. Pulpitis is caused by inflammation inside the tooth and can cause severe tooth pain, which can end up with a trip to an emergency dentist appointment. The good news is that pulpitis can be reversed if it is caught early and treated. Our professional dental team at Sninski & Schmitt Family Dentistry can diagnose and treat pulpitis to relieve your pain. In this article, we explain what pulpitis is, the different types, symptoms, causes, and treatments.

What is Pulpitis?

Pulpitis is the result of the innermost tissue in a tooth becoming inflamed. Pulp is the soft inner tissue of your teeth. It contains nerves, blood vessels, and connective tissue. The pulp supplies blood and nutrients to the hard, outer layers of your teeth to keep them healthy. It can get inflamed when there is an irritation inside a tooth due to things such as tooth grinding or a cavity. Bacteria enter through a cavity or crack causing the infection. Early pulpitis is reversible; however, inflammation that has not been treated is irreversible, will get worse, and require either a root canal or tooth extraction.

Two Types of Pulpitis

There are two types of pulpitis–reversible and irreversible. They are classified based on the extent of the infection.

  • Reversible pulpitis: When the inflammation is in the early stage, pulpitis is reversible if treated by your dentist. A dentist repairs the tooth and seals it with a filling.
  • Irreversible pulpitis: In this stage, the inflammation is more advanced and the tooth can’t recover. The pulp tissue eventually dies.

Symptoms of Pulpitis

There is a wide range of symptoms associated with pulpitis, usually categorized by either reversible pulpitis or irreversible pulpitis. The first symptom of pulpitis is pain. The pain can be sudden, intense, and throbbing, or it may be dull and achy.

Reversible Pulpitis Symptoms

  • Sensitivity to hot or cold that only lasts a few seconds
  • Sensitivity to sweet foods or drinks that doesn’t linger
  • Sharp pain
  • The tooth doesn’t hurt when it is tapped

Irreversible Pulpitis Symptoms

  • Intense pain
  • Spontaneous pain
  • Sensitivity to cold that lasts more than 30 seconds
  • Sensitivity to heat
  • Pain when the tooth is tapped
  • Swelling around tooth and gums
  • Bad breath
  • Fever
  • Pain that moves
  • Trouble finding which tooth is causing the pain

Causes of Pulpitis

Several factors can cause pulpitis.


A dental cavity is the most common cause of pulpitis. A cavity is a hole in your tooth caused by tooth decay from not properly brushing your teeth, bacteria, and sugar. Tooth decay can spread deep into your teeth and affect your dental pulp and roots.

Dental Work

Sometimes you can get pulpitis after a filling, crown, or other dental work. This can cause reversible pulpitis that can be fixed once the original dental work is repaired. It can progress into irreversible pulpitis if left too long. Major damage under the filling or amalgam can also cause irreversible pulpitis.

Cracked Tooth

A fracture in a tooth can reach into your dental pulp, expose the dentin and pulp, and cause inflammation. This can lead to pulpitis and pain. Here are some ways you can crack a tooth:

  • Biting down on something hard like an olive pit or a kernel of popcorn
  • Grinding your teeth
  • Repeatedly chewing on ice cubes
  • Old fillings or tooth restorations that weaken over time
  • Injury to your mouth or tooth

Advanced Periodontal Disease

Periodontitis is a serious gum disease caused by a bacterial infection. It typically starts with inflamed gums that aren’t treated properly. If not treated, periodontitis can cause bone loss and lead to pulpitis.

Treatment for Pulpitis

If your pain occurs in the night, there are some types of pulpitis treatments you can do at home that can help until you can see your dentist, including:

  • Over-the-counter pain medication can help minimize the pain and decrease inflammation
  • Propping your head up on a few pillows can help reduce inflammation building up in the area of the pulpitis
  • Use an ice pack to help reduce swelling

Treatment depends on the type of pulpitis and the cause.

Reversible Pulpitis Treatment

Reversible pulpitis is most commonly caused by a cavity, so removing and filling the cavity will take care of the problem. If your reversible pulpitis is due to clenching or grinding, you may need a long-term treatment that includes an occlusal guard.

Irreversible Pulpitis Treatment

Irreversible pulpitis pain is more difficult to treat. 

  • Root canal: It usually requires a root canal to remove the infected pulp to alleviate the pain or tooth extraction. Your dentist may refer you to an endodontist who specializes in treating pulp infections for a root canal. He/she removes the infected pulp and cleans out the root. Next, they fill the empty root canal and seal the tooth. A bit later you return to your dentist for a crown to cap the tooth.
  • Tooth removal: Sometimes the dentist recommends extracting the tooth and will discuss options for replacing the tooth, including a dental implant or dental bridge.


The best way to prevent pulpitis is by practicing good oral hygiene. Be sure to let your dentist know right away if you are having any tooth pain or sensitivity.

  • Brush your teeth two times a day for two minutes each time.
  • Floss every night.
  • Use a fluoridated toothpaste and mouthwash.
  • See your dentist for routine cleanings and checkups.
  • Avoid sugary or acidic foods and drinks.
  • Eat a healthy balanced diet with plenty of calcium.
  • Wear a night guard if you grind your teeth at night.

Contact Us to Schedule an Appointment for Tooth Pain

If you are experiencing tooth pain, including sensitivity to cold and hot foods and drinks, contact us for a proper diagnosis and treatment. You may have pulpitis that needs to be treated before it becomes an extreme problem. Our dentists are experienced in determining the type of pulpitis you have and the best treatment for it. Call our Holly Springs dentist office at 919-600-6262 and our Cary, NC dentist office at 919-467-2203. Alternatively, please use our convenient online form below to schedule an appointment.

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