Pulsating tooth - the onset of pulpitis.

Pain is undoubtedly the main symptom of inflammation and infection of the teeth.Most pathologies affecting the human oral cavity, in fact, are marked by the occurrence of different types of pain, depending on the real cause behind it.

One of these is certainly the feeling of tooth pulsation, a phenomenon that is capable of causing quite a few headaches for those who suffer from it. What is this type of pain determined by? What is the pathological condition most frequently associated with it? What are the remedies for relieving pulsating tooth pain?

We will answer these questions in this article, trying to provide as much detail as possible on the subject.

Pulsating tooth: the development of pulpitis

Classic inflammation is characterized by four distinct symptoms: pain, redness, swelling, and reduced function. In the oral cavity, these symptoms manifest during pulpitis, which is the inflammation of the dental pulp—the innermost and nerve center of the tooth.

The swelling associated with this type of inflammation becomes trapped within the dentin, creating pressure that results in intense, pulsating pain. This pressure can also abruptly cut off the blood supply to the pulp, ultimately leading to its death.  

Although the onset of pulpitis is often sudden, the oral cavity provides clear warning signs of a bacterial attack on the dental pulp. Patients may notice heightened sensitivity to cold or hot foods and beverages, as well as sugary items. Pain during chewing is another common symptom, indicating an advanced stage of pulpitis.  

The pulsating pain caused by pulpitis is often described as one of the most excruciating sensations a person can endure, as it can become constant and increasingly severe. Compounding the issue, it is often difficult to identify the exact tooth affected by necrosis, as the pain may radiate throughout the entire area. 

What causes pulpitis?

The causes and stages of pulpitis

Generally speaking, pulpitis originates from the presence of deep caries that has been neglected for a long time, caused by the infiltration of bacteria that have colonized the pulp.

In addition to this, various chronic traumas or structural abnormalities can also be responsible for the onset of pulpitis, such as bruxism, improper chewing or common dental malocclusions, bad habits that can cause lesions or microfractures in the teeth that expose them to bacterial infections.

In much rarer cases than those mentioned above, pulpitis originates from an inordinate number of thermal stimuli.

Pulpitis is a disease that can attack the tooth in various forms, depending on its reversibility or its ability to progress.

The most common types of pulpitis include:

L’iperemia pulpare, caratterizzata da un improvviso dolore in risposta ad uno stimolo termico che nasce durante i pasti. Questo processo può essere reversibile e può regredire spontaneamente, sempre se individuato tempestivamente.

La pulpite reversibile, tipologia dell’omonima condizione patologica alla quale si arriva quando l’infezione ha già colpito la polpa, ma l’infiammazione ha causato danni abbastanza circoscritti e di lieve entità. In questo stadio, il paziente prova un’altissima sensibilità al freddo e ai cibi zuccherati, oltre a dolore quando morde un alimento.

Pulpite irreversibile, diametralmente opposta rispetto alla tipologia appena descritta poiché caratterizzata da un dolore pressoché continuo e irradiato ai tessuti circostanti, avvertito anche a riposo o durante le ore notturne.

Pulpite necrotica, ultimo stadio della patologia, la quale causa la morte definitiva del dente e rende necessaria la sua devitalizzazione, ossia la sua ricostruzione totale. In questa fase, il paziente non avverte più la sensazione di dolore pulsante dato che il dente morto non ha più sensibilità e non è più in grado di ricevere stimolazioni dolorifiche.

Dente che pulsa:   quanto dura il dolore

Chi è affetto da dolore pulsante al dente, oltre a domandarsi come alleviarlo, si chiede quanto possa durare.

La risposta a tale quesito dipende dalla tipologia di pulpite che ha colpito il dente: in caso di pulpite reversibile, ad esempio, il dolore scompare non appena viene rimossa la reale causa scatenante l’infiammazione tramite intervento dentistico.

Se si tratta di pulpite irreversibile, il dolore potrebbe restare per molto più tempo, a seconda dello stadio che la condizione patologica ha raggiunto al momento dell’intervento del dentista, dato che essa può facilmente evolversi in necrosi portando alla formazione di granulomi, cisti o ascessi dentali.

In questo caso, non è possibile lenire efficacemente il dolore senza intervenire sulla parte più profonda del dente, la polpa, tramite un intervento di devitalizzazione o un’estrazione radicale.

Dente che pulsa:

- Pulpal hyperemia, characterized by a sudden pain in response to a thermal stimulus that arises during meals. This process may be reversible and may regress spontaneously, again if detected early.

- Reversible pulpitis: This form of pulpitis occurs when the infection has reached the pulp but has caused only minor and localized inflammation. At this stage, the patient may experience heightened sensitivity to cold and sugary foods, along with pain when biting.

- Irreversible pulpitis, diametrically opposed to the type just described as it is characterized by almost continuous pain radiating to the surrounding tissues, felt even at rest or during the night hours.

- Necrotic pulpitis, the last stage of the pathology, which causes the final death of the tooth and necessitates its devitalization, that is to say, its total reconstruction. At this stage, the patient no longer feels the pulsating pain sensation since the dead tooth no longer has sensitivity and is no longer able to receive painful stimulation.

Pulsating tooth: how long does the pain last

Those experiencing pulsating tooth pain often wonder not only how to relieve it but also how long it will persist.

The duration of the pain depends on the type of pulpitis affecting the tooth. In cases of reversible pulpitis, the pain subsides once the underlying cause of the inflammation is addressed through dental treatment.

However, with irreversible pulpitis, the pain can last much longer, depending on the progression of the condition at the time of the dentist’s intervention. This form of pulpitis can lead to complications such as necrosis, granulomas, cysts, or dental abscesses. In such cases, effective pain relief requires addressing the pulp directly through procedures like devitalization or tooth extraction.

Pulsating tooth: how to relieve the pain

While waiting to undergo the dental examination that will solve the problem, the patient could take specific steps to soothe the throbbing pain.

One of the most effective remedies is the use of analgesic and anti-inflammatory drugs, both NSAIDs and non-NSAIDs, based on ibuprofen or paracetamol. These medications can reduce swelling by acting on the inflammation affecting the tooth.  

In cases of unbearable pain, the dentist may prescribe opioid-based medications or codeine, which must be taken with caution due to their potential for causing addiction or dependency.  

Individuals suffering from pulpitis and experiencing pulsating pain can temporarily adjust their lifestyle and dietary habits. This includes significantly reducing the consumption of sugary foods and avoiding excessively cold or hot drinks, or those causing significant temperature fluctuations. Pain can be alleviated by consuming lukewarm foods or drinks, at a temperature of around 37 degrees Celsius, particularly if the pulpitis has a thermal origin.

In this regard, maintaining proper daily oral hygiene is crucial to preventing the worsening of dental conditions, the accumulation of plaque, or the development of caries in other teeth.  

Scheduling regular dental checkups is essential to monitor the condition of the oral cavity, helping to prevent potential abnormalities or address underlying pathological conditions that may progress unnoticed, without obvious signs or symptoms.  

Ultimately, the only definitive solution will come from the dentist, who, with the aid of diagnostic tools such as x-rays or panoramic dental imaging, will pinpoint the exact cause of the pulsating tooth pain. This allows for timely intervention before the condition worsens or requires more extreme treatments.  

The dentist’s goal is always to alleviate the patient’s discomfort while addressing the root cause of the issue. Therefore, seeking their assistance is essential for combating dental pathologies effectively.