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Pulpitis - procedure & treatment of the inflamed dental nerve

An inflamed dental nerve (in technical terms Pulpitis called) is a very unpleasant experience.

  • Few dental problems cause such pain.
  • That is reason enough to put this comprehensive guide together.

Here you can find out everything about the causes, treatment at the dentist and measures you can take to alleviate the symptoms yourself.

What is an inflamed tooth nerve (pulpitis)?

An inflamed tooth nerve is a rather unpleasant thing - the inflammation often manifests itself as a very severe toothache.

Strictly speaking, this is an inflammation of the pulp inside the tooth (called pulpitis). This consists of nerve tracts, blood vessels and tissue.

In technical terms, the tooth pulp is also called tooth pulp - just like in the graphic above. The nerves are connected to the rest of the body via the root canal - and usually cause great pain.

How does the inflammation of the tooth pulp develop?

The pulp keeps the tooth alive and supplies it with nutrients.

  • If this is attacked and the inflammation remains untreated, the tooth dies piece by piece and can no longer be saved.
  • Typically, the external structures, such as the enamel and dentin, protect the inside of the tooth.

However, if germs penetrate this protective barrier, the tooth nerve becomes inflamed (sometimes tooth root inflammation also occurs). In the following sections I have collected the most common causes of tooth nerve inflammation:


Advanced tooth decay is the most common cause of inflammation of the tooth nerve (pulpitis).

The attacked tooth enamel makes it easy for the bacteria to attack the internal structures and cause local inflammation.

If the hole in the tooth is left untreated, the symptoms can spread to neighboring teeth and cause further damage and inflammation of the gums there.

Often only large fillings help, or the doctor even has to pull the tooth out.


Experts mean damage like broken teeth. Pulpitis can also result from an accident or a hard blow to the tooth.

Periodontal disease

An advanced inflammation of the periodontium also leads to pulpitis. However, this is only extremely rarely the case. It is much more likely that the tooth will fail completely beforehand.

Reading tip: Everything about periodontal disease - this is how you can recognize the widespread disease as early as possible & prevent it correctly.

The consequences of untreated pulpitis

If left untreated, the inflammation spreads further and further in the pulp. In the end, the tooth dies completely, often leaving behind a purulent abscess.

The inflammation can then also affect the jawbone itself, causing jaw pain and spreading throughout the body, all the way to the heart.

In very rare (!) Cases, the untreated infection leads to death. The earlier you act, the better the chances of success.

What are the symptoms?

How do you know if your pulp has become infected? Usually such an inflammation does not come as a surprise, but rather brings with it a whole series of signs:


Of course, as a person affected, you have pain - and not too little. The pain is very strong and almost unbearable without painkillers. These increase more every day.

If the pain suddenly disappears, caution is advised: the nerve may have died and with it the whole tooth.

Reading tip:What helps with toothache?


In addition to the severe pain, there is also a throbbing that increases after consuming caffeinated drinks, a hot bath or sports activities.

Redness of the gums

The gums on and around the affected tooth are moderately to severely reddened. Even without medical training, you can see that the gums stand out in color.

Swelling of the gums

Most of the time, the whole cheek on the affected side is also slightly inflated. You may not suffer from a thick cheek, but the gums are noticeably swollen.


When you eat hot / cold / sweet or sour foods, you will notice a pull in the tooth.

The tooth is particularly sensitive in pulpitis. Sometimes even breathing in cold air leads to a drag because the irritation can also cause exposed tooth necks to form.

Pus formation

If the inflammation is severe, pockets filled with pus, called abscesses, can also form, which can also spread.

Swollen lymph node

The lymph node on the neck may swell. The lymph node enlarges on the affected side.

Procedure & different types of pulpitis

A general distinction is made in dentistry between acute and chronic pulpitis.

From a complaint period of three months it is a chronic disease, before that it is an acute one.

First stage - hyperemia

First of all, the inflammation forms. Germs have lodged in the tooth pulp and our immune system reacts.

The small blood vessels expand and transport antibodies to the affected area. The redness forms.

The early acute pulpitis

After the redness builds up, the tissue secretes a clear liquid called the Exudate referred to as. The first symptoms appear and pain can occur.

Late acute pulpitis

The defense is still in full swing.

Fluid is still secreted, but no longer transparent, but mixed with pus (the body tries to remove the inflammation-causing bacteria from the inside).

The second stage: chronic closed pulpitis

This is the most common type of pulpitis. As the name suggests, the inside of the tooth is closed again here.

  • In this phase the body tries to contain the inflammation again and to protect the irritated tooth pulp.
  • It does this with a build-up of white blood cells and tissue fluid that act as a kind of protective shield.

The body shoots the inside (provisionally) & it is again protected from outside influences. The symptoms gradually weaken and many sufferers feel a significant improvement.

But: The inflammation can return at any time. Symptoms such as bad breath, (pus) blisters in the mouth or frequent inflammation of the gums are also likely.

The body does its best to contain the bacterial focus, but the pulpitis actually persists. Even small accidents can destroy the protective shield:

Chronic open pulpitis

A hard blow or other form of trauma breaks the shield open and the pulp tissue is exposed again.


If the inflammation continues untreated, a growth forms on the surface of the pulp. Then threatens:

Granulating form of pulpitis

If the blood supply is large enough, more and more immune cells come to the inflamed area and begin to destroy the tissue.

This creates a granulating structure (grain formation).

This then grows further and further and finally grows out of the tooth pulp into the oral cavity. Often the tooth can then no longer be saved.

What can I do to calm an irritated nerve?

A visit to the dentist is always recommended if you suspect a dental nerve infection. However, it often takes a few days before you get an appointment.

In the meantime, you can try to calm the inflamed area down.

There are all kinds of tried and tested home remedies for an irritated tooth nerve that can relieve symptoms and pain.

As always: This guide on the Internet is no substitute for a visit to the doctor!

Rosemary for an irritated tooth nerve

The essential substances in rosemary help relieve pain.

  • Just chew on fresh or dried rosemary for a few minutes and then spit it out.
  • Alternatively, you can also prepare a tea infusion. Simply pour boiling water over the rosemary and let it cool down.

Gargle the cold tea for several minutes and then spit it out. Use the mouthwash several times a day.

Cold on an irritated tooth nerve

The cold is great for relieving swelling.

Just take an ice pad* and wrap it in a tea towel. Use it to cool the affected cheek for about 5 - 10 minutes. Repeat this several times a day.

But be careful: never put it directly on the skin, otherwise there is a risk of freezer burn.

Apple pieces for an irritated tooth nerve

The best thing to do is to take a chilled apple and cut it into bite-sized pieces.

Chew on it carefully. The sweet taste distracts from the pain and the chilled apple soothes the swelling.

High-proof alcohol for an irritated tooth nerve

No, you shouldn't get drunk with vodka, gin and co. However, high-percentage clear alcohol has a disinfectant effect and harms the bacteria.

Simply gargle a shot glass full of clear alcohol for about 1 minute and then spit it out. Repeat several times a day.

Here, too, caution is advised: Alcohol permanently causes dry mouth and more discomfort. Use only in an emergency.

Chamomile for an irritated tooth nerve

Chamomile soothes and has a decongestant effect. Just make a concentrated chamomile tea.

Take 2 tea bags of chamomile tea and pour 250 ml of boiling water over them. Let cool and then gargle. Repeat several times a day.

Tip: The herbal mixture is also ideal as a calming sleep tea for better sleep.

Garlic for an irritated tooth nerve

Garlic not only tastes delicious, the little miracle toe also has an antibacterial effect and strengthens the immune system.

Just add a few toes to your food.

For a better effect: bite a raw toe and hold this position for a few minutes. The essential oils are released and kill the bacteria.

Mouthwash for an irritated tooth nerve

Mouthwash is an excellent addition to daily dental care. It not only refreshes, but also has an antibacterial effect.

Gargle for 1 to 2 minutes after brushing your teeth in the morning and evening and then spit out.

Tip: Here you will find the best mouthwashes in the test.

Propolis for an irritated tooth nerve

Another valuable gift from bees besides honey is propolis.

Propolis has an antibacterial effect and is therefore often used for canker sores.

You can either put the propolis tincture directly on the affected tooth with the help of a cotton swab.

Or dilute 5 - 10 drops in water and use the mixture as a mouthwash.

Salt for an irritated tooth nerve

Salt is a popular product because it is anti-inflammatory. Another plus point: it can be found in every household.

Simply dissolve a tablespoon of salt in warm water and use it as a gargle several times a day.

Oil pulling on an irritated tooth nerve

Oil pulling was already used very successfully for toothache in the Middle Ages.

The oil absorbs pathogens and toxic substances and binds them.

  • Use a good quality, cold-pressed oil. Either virgin coconut oil or virgin olive oil in high-quality organic quality is best suited.
  • Put a tablespoon of oil in your mouth and slide it back and forth through your teeth for a few minutes. Then spit it out.

Repeat this several times a day. You can find more information about oil pulling in the article on the positive effects of coconut oil on teeth.

Tea tree oil for an irritated tooth nerve

Tea tree oil is often used for acne and small pimples. It has an antibacterial effect and inhibits reddening.

Take either pure tea tree oil and dab it on the affected area with a cotton swab.

Or dilute a few drops in water and use it as a mouthwash.

Hydrogen peroxide for an irritated tooth nerve

You can buy 3% hydrogen peroxide solution from the pharmacy. This has an antibacterial effect and helps fight inflammation.

Dab it directly on the affected tooth with the help of a cotton swab.

Cinnamon for an irritated tooth nerve

This is more of an unknown home remedy for dental problems, because it not only spices up our morning porridge. Cinnamon is a real all-rounder.

Simply rub the affected area with a little cinnamon. Use your fingers to do this.

Pain relievers for an irritated tooth nerve

If nothing works, painkillers from the pharmacy can still help. Ibuprofen or paracetamol are often used here.

Because these drugs not only relieve pain, but also have a decongestant effect.

Going to the dentist - treat pulpitis

If you don't notice any relief after a few days and all these tips, you have to bite the bullet and see your dentist.

Incidentally, this is also recommended when the symptoms have improved - don't be afraid of the dentist.

  • The choice of therapy depends on how far the inflammation has progressed.
  • Based on this, your dentist will choose a suitable form of therapy to properly combat pulpitis.

The most common variants can be found here:

The filling therapy

At the beginning, tooth decay is noticed by white spots on the tooth surface.

  • As it progresses, it continues to eat its way through the tooth enamel and leave holes behind.
  • At the onset of tooth decay, your dentist can close the small extinguishers with a filling and thereby prevent inflammation.

If detected early, nothing more needs to be done than filling therapy - white composite fillings cannot be seen and are one of the best treatment options.

The root canal treatment

If the inflammation is already deeper, you must undergo a root canal treatment.

  1. In several sessions, your dentist will open the affected tooth and remove the affected tissue.
  2. The doctor then carefully cleans the root canals before closing the tooth again.

The tooth remains, but is considered "dead".

Read more about this here: Everything about the process of a root treatment.

The apicectomy

If the pulpitis has already developed into periodontitis, the root tips must be removed.

  1. The doctor not only removes the tips of the tooth roots, but also the surrounding tissue.
  2. In most cases, a fluid-filled cyst has also formed, which must also be surgically removed.

The tooth is also retained here. It may be clinically dead, but you can still use it. A dental crown is often put on for additional protection.

Note: Read more about root resection here.

Removal of the tooth

If the inflammation is so advanced that no tooth-preserving measures can help, the entire tooth must be extracted.

This is the only way for the dentist to ensure that other structures and teeth are not attacked in the further course of the advancing pulpitis.

Then expensive dentures such as implants or dental bridges are usually necessary.

Prevent inflamed dental nerves - this is how it works

Dental problems are sometimes the worst as they spread quickly. Once the teeth are gone, they usually never come back.

You can do a lot in advance to enjoy your own teeth for as long as possible.

Proper dental care

Brushing your teeth is essential.

  • Because only through thorough cleaning, the pathogens cannot cause any damage.
  • Brush your teeth 2-3 times a day, morning and evening after eating. It is best to use an electric toothbrush.

Because no manual toothbrush has been scientifically proven to clean as thoroughly as an electric one, because such models partially compensate for faulty cleaning technology & ensure that we keep the correct cleaning time.

More information and recommended models can be found here: Electric toothbrushes put to the test.


Many dentists recommend the additional use of mouthwash.

Simply gargle for a few minutes after brushing your teeth and then spit out. Mouthwash not only ensures fresh breath, but also has an antibacterial effect.


The tried and tested thread ensures that all residues are removed from between the teeth.

This is where germs prefer to nest and even the best toothbrush cannot reach them there.

Dentists therefore recommend flossing every day. If you can't cope with this, there is also a convenient alternative.

Mouth rinses

With the help of pressure, the oral irrigator rinses the mouth with plenty of water. In this way, all food residues and bacteria are rinsed out of the mouth.

Simply rinse your mouth thoroughly again after your usual dental care. The best models can be found here: Mouth irrigators in the test.

Toothpaste containing fluoride

When brushing your teeth, use toothpaste containing fluoride (fluoride strengthens the enamel) without tooth-whitening particles like those found in black toothpaste.

Because these particles act like sandpaper, which removes the top layer of the tooth enamel. This makes the teeth much more sensitive and fragile. Recommendations can be found here: toothpaste in comparison.

Elmex jelly

Many dentists recommend the additional use of Elmex jelly*. This is a concentrated gel that contains fluoride.

Brush your teeth once a week after brushing your teeth normally.

Avoid sweets

Try to avoid sugary foods and drinks as much as possible.

Because sugar is the perfect breeding ground for bacteria and tooth decay is the result.

A balanced diet

Eat a balanced diet with lots of vegetables. Because this is the only way to support a healthy immune system.


Regular exercise helps a healthy immune system and prevents all kinds of diseases.

Much water

Drink and gargle plenty of water, at least two liters a day. Because a dehydrated body produces less saliva.

Saliva is our body's shower and washes away leftover food and germs.

to chew bubble gum

Regular chewing of sugar-free gum increases the production of saliva.

This way, leftover food and germs are simply washed away. There are a few recommendations here: Dental care chewing gum in the test.

Regular check-ups at the dentist

Go to your dentist for a check-up every six months. Because this way you can recognize and treat dental problems early on.

This way you avoid complications.

Professional teeth cleaning

Despite having good dental hygiene, it is advisable to clean your teeth thoroughly and professionally once a year.

Professional teeth cleaning at the dentist not only removes tartar, but also gives you a unique feeling of cleanliness.

Closing word

So you see: it is advisable to pay attention to thorough dental care. This only takes a few minutes and saves you expensive and unpleasant visits to the dentist in the long term.

With thorough and careful oral hygiene, you can do a lot yourself against inflamed dental nerves and lengthy treatments.

The most important points again at a glance:

Hope this article has been helpful to you. Please recommend this page to friends and acquaintances in order to help as many people as possible.

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