It’s not that we’re superficial. It’s just that most of our daily dental activities deal with surface issues. Are we brushing too hard? Flossing enough? Is there visible plaque? Or invisible plaque? Are our teeth gleaming white?
And these are all good questions—for another day. Today, we’re going to go below the surface, under the enamel, beneath the dentin, and talk about the substance that fills the inside of each tooth—our pulp.
The outer surface of the tooth crown is covered with enamel. This protective, mineralized coating is the hardest substance in the body. Cementum, a hard connective tissue, covers the roots of the tooth. Underneath the enamel and cementum surfaces, we find dentin, a layer slightly softer than enamel, which makes up most of the tooth. And inside the dentin lies the pulp chamber.
This chamber holds the tooth’s pulp, which is living tissue made of nerves, blood vessels, and connective tissue. Nerves and blood vessels travel from the chamber through our root canals, where they enter and exit through a small opening in the root tip, connecting to our nervous and circulatory systems. Healthy pulp performs several important functions, which help protect healthy smiles:
The nerves in the pulp allow us to feel temperature and pressure. They also alert us when a tooth is decayed, damaged, or infected. Sensitivity and pain are warnings that a visit to your dentist is in order.
Tiny blood vessels provide oxygen and nutrients to the pulp cells. The pulp, in turn, nourishes the dentin and keeps the tooth from becoming brittle.
- Creating new dentin
Unlike enamel, which can’t be replaced or regenerated, dentin production is ongoing, and it begins with cells called odontoblasts, which are found in the pulp.
Even though this tiny organic system is well protected by the tooth’s outer layers, tooth pulp is still vulnerable to damage:
When a cavity isn’t treated quickly, decay can progress from the enamel through the dentin layer and reach the tooth’s pulp.
Accidents happen. And sometimes, an accident will expose the pulp of the tooth. Or the pulp can be affected by repeated dental treatments or tooth grinding. Or a fracture can extend into the pulp chamber.
Inflammation of the pulp is known as pulpitis. Sometimes pulpitis is mild and reversible, when the source of pulp irritation (a small cavity, for example) is treated. But sometimes it is not.
Irreversible pulpitis occurs when bacterial infection or pulp trauma is severe, and prompt treatment is necessary. When inflammation and swelling lead to the death of pulp tissue, acute pain, spreading infection, and tooth loss can result. Whenever the health of your tooth pulp is in question, it’s always a good idea to see an endodontist.
The word endodontic means “inside the tooth,” and endodontists, like Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants, are the expert in pulp-related issues, saving teeth, which could otherwise be lost. While all dentists receive some endodontic training in dental school, endodontists receive two or three years of additional advanced training, concentrating on the diagnosis and treatment of diseases and injuries that affect the inner tooth and its supporting tissue.
One of the most common treatments for irreversible pulpitis is a root canal. In this procedure, done at our Worcester office, the infected or dead pulp tissue is removed (a procedure called a pulpectomy), and the pulp chamber is cleaned, filled, and sealed. After treatment, a crown is usually placed to protect and restore the appearance of the tooth. Your tooth can still function without its pulp, and, even when the pulp can’t be saved, a timely root canal or endodontic surgical procedure can often save your tooth from extraction.
In perfect conditions, the strong mineralized layers of our teeth would be enough to protect our pulp. But since conditions aren’t always perfect, there are some simple steps you can take to reinforce the protection your enamel, cementum, and dentin provide:
- Keep up with regular dental hygiene and checkups
Decay won’t reach your pulp if you prevent it from ever developing in the first place. And if, despite your careful brushing and flossing, a cavity does form, regular checkups make sure your dentist catches decay early before it can affect your pulp.
- Protect your teeth
Avoid incidents which can expose pulp to trauma by wearing a mouthguard when you’re active, a night guard if you’re a tooth grinder, and a seat belt whenever you’re in the car. And don’t forget a helmet if your sport offers one!
- Be proactive
Never ignore severe or continuing tooth pain. Whatever the cause of injury or inflammation, once the pulp has been compromised, treatment needs to take place to prevent further infection, pain, and even tooth loss. Call Central New England Endodontics and Implantology, especially if extraction is recommended. Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our team work to save injured teeth with a variety of procedures, including root canals, treatment of injuries caused by trauma, and endodontic surgeries.
This is just a bit of the inside story on pulp. If you have questions or concerns about your pulp, your teeth, or any facets of your dental health, talk to our Worcester team. We are experts in treating your teeth—inside and out!