Talk:Pulpitis

Pulp

Would be good to include in the article a description of symptoms of different stages of pulpitis an they ways they can be alleviated. As it is often the case with medical conditions, people look them up in wiki in order to get some clue about how to deal with them. —Preceding unsigned comment added by Tadju (talk • contribs) 15:40, 7 March 2008 (UTC)

What other biological organs have a pulp? — Pekinensis 22:23, 25 July 2005 (UTC)

Well, a fruit has a pulp. A fruit is an organ of a plant. Go figure. If you know for sure there are no other organs that have pulpitis, then change the article. 2004-12-29T22:45Z 22:43, 25 July 2005 (UTC)

Google has convinced me that pulpitis is restricted to the teeth. — Pekinensis 22:57, 25 July 2005 (UTC)

well... by definition pulpitis is inflammation of the pulp... the only part to have a pulp is teeth.

please also add the classification of the lesion ubder discussion —Preceding unsigned comment added by 119.152.72.27 (talk) 04:36, 25 May 2009 (UTC)

"A negative EPT response showed localized necrosis in 25.7% of cases and 72% of cases." Which cases? This doesn't make sense--would someone knowledgeable please correct this?216.40.140.18 (talk) 09:21, 11 December 2012 (UTC)

Broken sentence

Inflammation associated with a bacterial infection, as in the case of penetrating decay, the pulp chamber is no longer sealed off from the environment of the oral cavity.

Maybe this should be changed to

Inflammation is associated with a bacterial infection, because in the case of penetrating decay the pulp chamber is no longer sealed off from the environment of the oral cavity.

However, I am not a dentist and am not sure what the author intended. --Keith111 (talk) 13:02, 26 August 2009 (UTC)

Acute suppurative pulpitis Merge

The article is a subsection of this article, and there's no references or new information in the former article. Moreover, some sources (like [1] this) suggest the term is obsolete and better called a irreversible pulpitis. Shadowjams (talk) 06:55, 1 December 2009 (UTC)

• Endorse merger. –blurpeace ^(talk) 10:24, 1 December 2009 (UTC)

Agree with merge. Ashley Payne (talk) 23:04, 1 December 2009 (UTC)

Possible sources about infections, living in the dead tooth

G: gingival crevice (periodontal pocket), I, J, K: periodontal ligament fibers

Hi. Please, check are these sources good for article and should we add information about negative consequences of treating root canals? `a5b (talk) 17:10, 28 January 2014 (UTC)

• Dr. Mercola (February 18, 2012). [articles.mercola.com/sites/articles/archive/2012/02/18/dangers-of-root-canaled-teeth.aspx "Why Don't You Try This?: 97% of Terminal Cancer Patients Previously Had This Dental Procedure..."] Retrieved 2014-01-28. {{cite web}}: Check |url= value (help)
• "Root Canals Contain Toxic Bacterium". Retrieved 2014-01-28.
• Root Canal Cover-Up, George Meinig, Bion Publishing (CA), 1994, ISBN 9780945196198

Hi A5b. Medical content on Wikipedia needs to be supported by reliable, mainstream sources. Usually this means review papers (ideally systematic reviews) published in peer review journals, and mainstream medical textbooks. Please see: WP:MEDRS for more info.

I would comment that there is no cover up here. I was taught about the complexity of the root canal system when I trained. Agree often root canal merely reduces the bacterial load inside the root canal system to a level which the body's immune system can tolerate (much the same as it tolerates the presence of a certain level of bacteria living below the gumline, or in the tonsils). I would always emphasize that root canal treatment may not work. This is a medicolegal and moral necessity.

Retention of the dead tooth shell for cosmetic reasons is usually demanded by patients. One of the sources you placed above mentions the alternatives, bridge, denture, implant. All of these oral prostheses become covered in bacteria. They are "plaque retention factors". I am not pushing root canal above these methods, but they are not perfect alternatives.

Also, this statement particularly stood out to me as false:

"Dentists are taught to remove the tooth but leave your periodontal ligament. But as you now know, this ligament can serve as a breeding ground for deadly bacteria. Most experts who've studied this recommend removing the ligament, along with one millimeter of the bony socket, in order to drastically reduce your risk of developing an infection from the bacterially infected tissues left behind."

The periodontal ligament holds the tooth in the jaw bone. Between the tooth and the gum, there is a small pocket, the gingival crevice (termed "periodontal pocket" if gum disease deepens the pocket >3mm). This pocket ("below the gumline") has a degree of subclinical inflammation even in someone who flosses everyday and has very good oral hygiene. When a tooth is removed, part of the ligament comes off still attached to the tooth and the rest stays behind in the empty socket. The gingival crevice no longer exists once the tooth is gone. The area in which the bacteria where living is gone. As for the section of the periodontal ligament that is retained in the socket, it is needed by the body to begin the healing process of filling in the empty socket with bone. The cells that used to be the soft tissue of the periodontal ligament will eventually become the soft tissue that covers the socket. It also lays done a framework inside the socket for bone to fill in as the healing progresses.

By removing the periodontal ligament after performing a tooth extraction, one interferes with this normal healing process. The soft tissue instead would need to grow from the gums around the edge of the socket, which takes longer (see: Dry_socket#Causes).

That would also strongly increase the risks of complications like dry socket, infected socket, postoperative bleeding, etc. I strongly discourage any such technique, it will only delay healing, cause more postoperative pain, and in all likelihood probably increases the risk of a postoperative infection. It is counter-intuitive. Lesion (talk) 18:20, 28 January 2014 (UTC)

• See also focal infection theory. Kind regards, Lesion (talk) 18:23, 28 January 2014 (UTC)

• Thank you, Lesion. Are there any connections between insafety of treated root canals and medical states when the human has very weak or no immunity (for example in oncology when doing radiotheraphy/chemoradiation and Bone Marrow Transplant)? `a5b (talk) 23:24, 28 January 2014 (UTC)

I don't know enough about endodontics to comment in detail. The sources you placed above seem to be proponents of the focal infection theory ... I understand this view is not particularly mainstream nowadays. In immunocompromized persons with acute dental infection, these are treated much more aggressively least things get out of hand. Also, people who have bad teeth and who are about to undergo radiotherapy directed at the jaws often have the doubtful teeth removed to prevent later osteoradionecrosis of the jaws. Lesion (talk) 16:52, 29 January 2014 (UTC)

• Something else regarding scraping (debriding) the socket after an extraction: Some (usually older) dentists and oral surgeons do this routinely. They do this not to remove the remaining periodontal ligament and prevent infection, but in the belief that it will encourage bleeding and therefore make a blood clot in the socket, making dry socket less likely to happen. Note that dry socket (loss of blood clot from socket) is not the same as an infected socket. As I mentioned above, there is no evidence that scraping out the socket reduces the chance of dry socket or infection. As far as I am aware, this practice is reducing as practitioners start to more closely adhere to evidence-based medicine. Lesion (talk) 16:58, 29 January 2014 (UTC)

Sourcing

Needs to be updated with current MEDRS. This list gives systematic reviews on the topic, there are six done within the past 5 years. LeadSongDog come howl! 19:05, 9 April 2018 (UTC)