Pulp Degeneration

A tooth with reversible pulpitis can have severe pain made worse by temperature changes. Pulp necrosis may leave the tooth yellow, gray, brown or black.

Dental infections can begin in the tooth or its supporting structures. When bacteria invade the pulp, infection can spread into surrounding tissues.

Pulpitis can progress from temperature-sensitive pain to more constant pain as vitality deteriorates into irreversible pulpitis and necrosis. A necrotic pulp can be followed by a periapical abscess.

Fever, facial swelling, difficulty opening the mouth, swallowing difficulty, drooling, a swollen mouth floor or voice change can signal infection beyond the mouth.

History and examination identify early local pain or swelling. Dental radiographs can show caries, a periapical abscess or bone loss that is not obvious on visual examination.

Definitive care removes the source of infection through drainage, endodontic treatment or extraction. Antibiotics alone delay proper treatment and can increase the risk of systemic spread.

Infection can extend from a necrotic pulp into surrounding tissues. Deep-space infection can require hospital admission, intravenous treatment and sometimes an operation.

Untreated dental infection can spread into deep spaces of the neck, the mediastinum, facial sinuses or brain. Airway compromise and sepsis are serious complications.

Daily toothbrushing, flossing and reducing sugar-containing foods help reduce cavities. Early identification and treatment reduce the prevalence of dental infections and serious complications.