The tooth may look like a simple structure from outside, but it is a complex organ, designed to help in chew and speak. If you cut the tooth in half, you would see the pulp chamber at the center of the tooth, between the crown and the tooth’s root canals.

The pulp is the sensory center of the tooth which provides the blood and nerve supply. It is the most vital part of the tooth. Once your tooth is decayed, the bacteria can enter the pulp chamber and affect your sensitive tooth pulp.

There are many easy things you can do to keep your pulp chamber healthy. But first, you should know something about the pulp chamber.

This article will help you understand about pulp chamber and the complications related to it.

What is pulp?

The pulp is the neurovascular bundle central to each tooth, permanent or primary. It comprises a central pulp chamber, pulp horns, and radicular canals.

The large mass of pulp is contained within the pulp chamber, which is held in and mimics the overall shape of the crown of the tooth.

It is divided into two portions –

  • Coronal portion/ part within the crown – pulp chamber
  • Radicular portion/ part within the roots – root canal

The tooth pulp is soft and consists of living blood vessels, connective tissue, and large nerves.

tooth anatomy with labels

What is the function of the pulp?

There are many functions of the pulp, with the primary purpose being to form dentin. Some of the other functions include:

  • Nutritive – the pulp keeps the organic components of the surrounding mineralized tissue supplied with moisture and nutrients.
  • Protective/ Sensory – extremes in temperature, pressure, or trauma to dentin or pulp are perceived as pain.
  • Defensive/ Reparative – the formation of reparative or tertiary dentin.
  • Formative – cells of the pulp produce dentin, which surrounds and protects the pulpal tissue.

How to test the health of the pulp?

The health of the dental pulp can be established by a variety of diagnostic aids, which test either the blood supply to a tooth or the sensory response of the nerves within the root canal to specific stimuli. (1)

Although less accurate, sensitivity tests, such as electric pulp tests or thermal tests are more routinely used in clinical practice than vitality testing, which requires specialized equipment. (2)

What kind of responses can you get after pulp vitality testing?

1. Healthy pulp

A healthy, normal pulp is vital and ordinarily responsive to pulp testing. It is free from any symptoms and inflammation and has a mild or transient response clinically to thermal and cold testing. These responses don’t last more than 1-2 seconds after the stimulus is removed.

2. Reversible pulpitis

Reversible pulpitis is a mild to moderate inflammation of the pulp by any momentary irritation or stimulant.

The pulp still gives a natural response to sensibility tests and the inflammation resolves with the management of causes. There are no significant radiographic changes near the root canals. (3)

3. Irreversible pulpitis

Irreversible pulpitis is diagnosed when the pulp is inflamed and infected beyond the point of no return and healing of the pulp is not possible.

The pulp is still vital and vascularized. In irreversible pulpitis, the pain lingers from minutes to hours, in response to thermal stimulation.

4. Pulp necrosis

The pulp tissue is either dying or dead. It can occur due to untreated caries, trauma, or bacterial infection. This condition is usually asymptomatic and may go unnoticed by the patient. X-rays, sensitivity testing or electric pulp tester, diagnose it.

How to treat pulpal complications?

Reversible pulpitis

Treating or eliminating the cause of the inflammation can treat reversible pulpitis. Early intervention can help prevent irreversible pulpitis. Regular follow-ups are required after the treatment to determine whether the pulp has returned to a healthy state.

Irreversible pulpitis

It requires root canal treatment or tooth extraction, based on the prognosis of the tooth. In root canal treatment, the inflamed pulp is eradicated, which relieves the pain.

The empty root canal system is then obturated with a rubber material called gutta-percha that acts as a pressure and pain reliever.

Pulp necrosis

If the necrotic pulp is left untreated, it can cause infection, fever, swelling, abscesses, and bone loss. A tooth with pulp necrosis needs to undergo root canal treatment or extraction to prevent further spread of infection.

Take away message

The tooth pulp is the most vital part of the tooth, originating in the center of the tooth, underneath the enamel and dentin layer, in the pulp chamber. It is soft and consists of living blood vessels, connective tissue, and large nerves.

Tooth decay from weakened enamel can reach the pulp chamber and expose the sensitive tissue, causing infection and inflammation.

There are many easy things you can do to keep your pulp tissue healthy. Avoid too many sugary snacks in your diet, and don’t forget to brush and floss twice a day.

In case you experience any pain or discomfort, schedule an appointment with your dentist as soon as possible.