What Causes Irreversible Pulpitis?

Irreversible pulpitis most commonly develops when bacteria or trauma damage the tooth’s nerve.

Common causes include:

• Deep tooth decay (cavities)
• A cracked or fractured tooth
• Trauma to the tooth
• Large or failing fillings
• Repeated dental procedures on the same tooth
• Excessive wear from grinding or clenching

Because the nerve is unable to heal once the inflammation reaches this stage, treatment is necessary to eliminate the source of the problem.

Signs and Symptoms

Symptoms may include:

• Severe toothache
• Sharp or throbbing pain
• Pain that lingers after drinking something hot or cold
• Pain that wakes you during the night
• Sensitivity when biting or chewing
• Pain that seems to come and go but gradually becomes more frequent

Some patients notice that the pain temporarily subsides before returning with swelling or signs of infection.

How Is Irreversible Pulpitis Diagnosed?

During your examination, Dr. Omeltschenko will determine whether the nerve inside your tooth is healthy, irritated, or no longer capable of healing.

Your evaluation may include:

• Digital X-rays
• Clinical photographs
• Cold testing
• Bite testing
• Examination for cracks or fractures
• Evaluation of existing fillings or crowns

Because several dental conditions can cause similar symptoms, a thorough examination is necessary before recommending treatment.

What Happens If It’s Left Untreated?

Irreversible pulpitis does not heal on its own.

Without treatment, the inflamed nerve will eventually die, allowing bacteria to spread into the bone surrounding the tooth.

This may result in:

• Necrotic (dead) tooth nerve
• Tooth abscess
• Increasing pain
• Swelling of the gums or face
• Bone loss
• Tooth loss
• Spread of infection

Prompt treatment often improves the chances of saving the natural tooth.

Possible Treatment Options

Treatment depends on the condition of the tooth and whether it can be predictably restored.

Possible treatment options include:

• Root Canal Therapy – The most common treatment for irreversible pulpitis. The inflamed nerve is removed, the canals are cleaned and disinfected, and the tooth is sealed to eliminate infection while preserving the natural tooth.

• Dental Crown – Because teeth requiring root canal therapy are often weakened, a crown is commonly recommended afterward to protect the tooth and restore long-term function.

• Tooth Extraction – If the tooth is too severely damaged to be predictably restored, extraction may be the best long-term option. If extraction is necessary, replacement options such as a dental implant or bridge can be discussed.

Whenever possible, our goal is to preserve your natural tooth while providing a treatment solution that offers long-term success.