SYMPTOMATOLOGY OF PULPATHIES
I. PHYSICAL SIGNS:
The anatomical situation of the pulp, in the depth of the tooth, considerably reduces the existence of these signs.
a. The crown usually retains its natural color (light yellow) except in the case of chronic ulcerative pulpitis and necrosis where the crown has a grayish color.
b. The possibility of seeing the pulp through transparency in the cases of:
– Significant dentin destruction
– Significant coronal fracture
– Internal granuloma.
c. In case the pulp cavity is open: the pulp appears either as a red (blood) or yellow (pus) or gray-brown (necrosis) point or polyp (hypertrophy).
II. FUNCTIONAL SIGNS:
a) Spontaneous pain:
These are spontaneous pains that appear only to the patient, but for the practitioner, they are actually caused by various congestive attacks occurring during pulp inflammation.
These are intermittent pains in the form of attacks separated by periods of complete remission, therefore discontinuous, throbbing, sometimes pulsating with exacerbations.
a.1 Intensity:
It is variable, can be subacute, acute or superacute or even paroxysmal. Pain is a subjective phenomenon, which depends on the psychological and nervous state of the patient and also on the importance of the compression of the pulp nerve fibres.
Pulpitis pain responds favorably to analgesics .
a.2 Duration:
the duration is variable, it can be a few seconds, minutes, or even hours, they begin and stop abruptly, linked to phenomena of congestion and rapid decongestion in relation to the size and situation of the pulp.
Its attacks are more or less frequent, often nocturnal, and can occur at fixed times called “Cyclalgia”.
The extent of these crises can be several days and in this case we have two developments:
Either everything seems to return to normal, the patient can go a long time without complaining of the illness again
Or an evolution towards chronicity replaced by a rapid evolution and pulpal pain is followed by periapical pain.
SYMPTOMATOLOGY OF PULPATHIES
a.3 Location:
The patient is able to localize his pain and to designate exactly the causal tooth, but it happens that the pain is radiated and projects to the neighboring, antagonistic teeth, the irradiations take place:
Towards the chin for the lower incisors.
Towards the ear for the lower premolars and molars.
Towards the nose for the upper incisors.
Towards the eye for the upper canines.
Towards the temple for the upper premolars and molars.
For lower DDS towards the neck AND shoulder.
b) Pain caused by:
Stimulated by the slightest contact, thermal variations, acid and sugar and unlike dentin syndrome, where the pain stops with the cessation of the stimulus, in pulp syndrome, the pain continues 1 to 5 minutes after the cessation of the stimulus.
c) Reflex phenomena:
Of sympathetic origin and are rarely observed, they can give rise to facial neuralgia, redness of the skin, nasal pruritus, alopecia areata, which can distort the diagnosis.
SYMPTOMATOLOGY OF PULPATHIES
Wisdom teeth can be painful if they are misplaced.
Composite fillings are aesthetic and durable.
Bleeding gums can be a sign of gingivitis.
Orthodontic treatments correct misaligned teeth.
Dental implants provide a permanent solution for missing teeth.
Scaling removes tartar and prevents gum disease.
Good dental hygiene starts with brushing twice a day.