Pulpitis and periodontitis: toothache and root canal treatment in Tashkent

Other names: Воспаление нерва зуба, лечение каналов, эндодонтия, киста зуба, флюс

Pulpitis is inflammation of the neurovascular bundle inside the tooth, and periodontitis is inflammation of the tissues surrounding the root. These are successive stages of one process: advanced caries reaches the pulp, causing pulpitis, and untreated pulpitis turns into periodontitis with a focus of inflammation at the apex of the root. It is pulpitis that causes that unbearable night toothache that keeps people awake. The good news is that modern endodontics allows you to save a tooth, even with a dead nerve, for decades.

🧾 МКБ-10: K04 🏥 Where it is treated: 6 Night pain is a sign of pulpitisThe tooth can be savedFlux - see a doctor immediately

👨‍⚕️ Which doctor

Dentist-therapist

🔬 Diagnostics

Examination, spotting, CBCT

💊 Treatment

Root canal treatment

📈 Prognosis

The tooth is preserved in most cases

⚠️ At risk

Advanced caries, tooth trauma

⏱ When to see a doctor

In case of swelling and fever - urgently

🚨 See a doctor urgently

With these signs do not wait for a scheduled appointment — the condition requires emergency care.

Отёк щеки, века, шеи — распространение гнойного процесса
Температура, озноб, выраженная слабость
Затруднение открывания рта, глотания или дыхания — экстренная ситуация
Боль, отдающая в глаз, ухо, висок с нарастанием
Онемение нижней губы и подбородка
Гнойное отделяемое of десны

How to distinguish one from another

Deep caries: pain occurs from cold, sweet, sour foods and goes away within a few seconds after the irritant is removed
Pulpitis: pain is spontaneous, paroxysmal, intensifies at night and in a lying position, radiates to the ear, temple, and neighboring teeth. It is often difficult to pinpoint which tooth is hurting
Periodontitis: the pain is constant, aching, clearly localized, sharply intensifies when biting; feeling of a “grown” tooth. Paroxysmal pain at night subsides, but pain appears when chewing
Periostitis (flux): pain is accompanied by swelling of the gums and cheeks, the temperature often rises

Стихание сильной боли не означает выздоровления. Часто это означает гибель пульпы и переход в периодонтит: боль ушла, а очаг воспаления у корня продолжает расти.

Canal treatment

Обезболивание и изоляция зуба коффердамом — латексной завесой, защищающей канал от слюны и бактерий.
Удаление кариозных тканей и вскрытие полости зуба.
Удаление воспалённой или погибшей пульпы, механическая и медикаментозная обработка каналов.
Определение длины канала и контрольные снимки.
Пломбирование каналов до верхушки корня.
Восстановление коронковой части: пломба, вкладка или коронка.

After root canal treatment, the tooth becomes more fragile. After endodontic treatment, it is recommended to cover the chewing teeth with a crown or inlay - this significantly reduces the risk of splitting.

Periodontitis and cyst

In chronic periodontitis, a lesion forms at the root apex - a granuloma, and then a cyst. It often exists without symptoms and is discovered by chance on an image.

The main method of treatment is high-quality retreatment of the canals; in many cases, the lesion resolves on its own within 6–12 months
Resection of the root apex - if endodontic treatment is ineffective
Tooth extraction - in case of significant destruction, vertical root fracture, inability to pass through canals
Follow-up images at 6 and 12 months to assess healing

Хронический очаг у корня — это постоянный источник инфекции в организме. Он может обостряться при снижении иммунитета и рассматривается как фактор риска при заболеваниях сердца и перед некоторыми операциями.

What to do in case of acute pain before your visit

Take painkillers at your usual dose
Rinse your mouth with warm saline solution
Clean the tooth from food debris
Sleeping with your head elevated - the pain gets worse in a horizontal position
DO NOT heat your cheek or apply warm compresses: heat accelerates suppuration
DO NOT place an analgin tablet on a tooth or gum - this causes a chemical burn to the mucous membrane
DO NOT attempt to pop the swelling yourself.

Frequently asked questions: Pulpitis and periodontitis

Why does my tooth hurt at night?+

In a lying position, the blood flow to the head increases, the pressure inside the inflamed pulp in the closed cavity of the tooth increases - and the pain increases sharply. This is a typical sign of pulpitis.

The pain went away on its own - can I not go to the doctor?+

It is forbidden. Most often, this means the death of the pulp and transition to periodontitis: the pain has gone, but the inflammation at the root continues to grow and can lead to a cyst and tooth loss.

Is it possible to warm your cheek with flux?+

Absolutely not. Heat accelerates suppuration and spread of infection. You need to see a doctor as soon as possible, and before the visit you can take painkillers and rinse your mouth with a warm saline solution.

Will the tooth survive after root canal treatment?+

Yes, in most cases the tooth lasts for decades. But it becomes more fragile, so it is recommended to cover the chewing teeth with a crown or inlay after canal treatment.

Is it necessary to remove a tooth with a cyst?+

Not necessarily. In many cases, high-quality retreatment of the canals leads to resorption of the lesion within 6–12 months. Extraction is considered if it is impossible to pass the canals or the tooth is destroyed.

The information on this page is for reference only and does not replace a doctor consultation. Only a qualified specialist can make a diagnosis and prescribe treatment after an in-person examination.