Acute Pulpitis

Pulpitis refers to inflammation of the dental pulp — the connective tissue, blood vessels, and nerves contained within the tooth's root canals and pulp chamber.

The condition exists on a spectrum from reversible pulpitis, where the pulp can recover after causative factor removal, to irreversible pulpitis, where pulp vitality cannot be maintained.

Distinguishing between these categories is critical as it determines whether vital pulp therapy can preserve the tooth or endodontic treatment is required.

Deep dental caries is the most common etiology, allowing bacterial toxins and eventually bacteria themselves to reach the pulp.

Trauma — acute blows to the tooth can cause direct pulp injury, disruption of the apical blood supply (luxation injuries), or crown fractures exposing the pulp.

Iatrogenic causes include excessive heat generation during cavity preparation, chemical irritation from restorative materials, and pulp exposure during procedures.

Periodontal disease can cause retrograde pulpitis when bacteria invade the pulp through lateral canals or the apex.

Cracked tooth syndrome leads to intermittent pulp inflammation from flexion forces along the crack.