Recognize the levels of pulpitis to avoid permanent tooth loss

Tran Hoai Nam
21/10/2026
Hoàng Vũ Hiệp

Professional Consulting

D. Hoàng Vũ Hiệp

Dentist

The levels of pulpitis cause unpleasant pain and seriously affect quality of life. However, not everyone clearly understands the levels of pulpitis and the danger of each stage.

Causes of pulpitis

Tooth decay not treated promptly

This is the leading cause. Bacteria from cavities will penetrate deep into the tooth enamel and dentin and eventually enter the pulp, causing infection.

Tooth trauma

Cracked or broken teeth due to accidents or impacts can expose the tooth pulp, creating conditions for bacteria to penetrate.

Severe tooth wear

When tooth enamel and dentin are worn down too much, the tooth pulp will easily become irritated and infected.

Periodontic disease

Gingivitis, inflammation Severe periodontal disease can spread to the tip of the tooth and cause pulpitis.

Improper dental treatment techniques

In rare cases, improper tooth treatment techniques can also cause pulp damage.

 

Levels of pulpitis

Normally, pulpitis is divided into main stages: reversible pulpitis, irreversible pulpitis (acute and chronic), and pulp necrosis.

1. Reversible pulpitis 

This is the first and mildest stage of pulpitis.At this stage, the tooth pulp is only slightly irritated and damaged, with no signs of serious infection. If detected and treated promptly, the tooth pulp can completely restore its original function.

Signs of recognition:

  • Transient sensitivity:Teeth feel sensitive and sensitive when exposed to food, drinks that are too hot or too cold, sweets, or sour foods. This feeling usually lasts for a few seconds and disappears as soon as the stimulus is removed.
  • No spontaneous pain:Pain does not appear naturally but only when there is a stimulating factor.
  • No pain when tapping the tooth:Trying to gently tap the tooth usually does not cause pain.

Viêm tuỷ răng có hồi phục

Reversible pulpitis

In this stage, treatment focuses on eliminating the cause of pulp irritation. If it is tooth decay, the doctor will clean the cavity and fill it. If it is due to tooth wear, a filling or porcelain coating can be used to protect the pulp. Proper treatment at this stage is key to preventing the disease from getting worse.

2. Irreversible pulpitis 

When pulpitis is irreversible, that is, the inflammation has become severe, the damaged tooth pulp cannot heal on its own and requires root canal treatment. Irreversible pulpitis is divided into two main types: acute and chronic.

Acute irreversible pulpitis

This is one of the most painfulgrades of pulpitis. The tooth pulp has been severely infected, often due to bacteria penetrating deeply and causing a violent inflammatory reaction.

Signs of recognition:

  • Severe spontaneous pain:Pain appears naturally, without stimulation. The pain can be dull continuously or sharp in waves, especially often appearing at night, when lying down.
  • Diffuse pain:Pain can spread to neighboring teeth, to the temple area, half of the head on the same side, making it difficult to accurately identify the painful tooth.
  • Prolonged pain:Pain lasts more than 15-30 minutes after removing the hot or cold stimulus.
  • Sensitivity to heat degree:Teeth are very sensitive to heat and cold, and the pain even increases when exposed to temperature.
  • Pain when tapping:The tooth may hurt when lightly tapping or biting.
  • Possible facial swelling and fever (if there is pus):In the case of acute purulent pulpitis, the patient may be accompanied by swelling of the corresponding facial area, mild fever, and swollen lymph nodes.

Ở giai đoạn viêm tuỷ răng không hồi phục điều trị tủy răng (lấy tủy) là phương pháp bắt buộc để loại bỏ mô tủy bị viêm nhiễm

At the stage of irreversible pulpitis, root canal treatment (root canal) is the required method. forced to remove infected pulp tissue

Chronic irreversible pulpitis 

Chronic pulpitis is one oflevels of pulpitisunpleasant, often occurring when acute pulpitis is not completely treated or when the inflammatory process persists for a long time.

Distinguishing signs:

  • Long-lasting dull pain:The pain is often dull, lasting many hours, with occasional bouts of pain. sudden throbbing.
  • Less intense pain than acute:The pain intensity is not as intense as acute pulpitis, sometimes only feeling uncomfortable and slightly sensitive when chewing.
  • There may be a fistula:In some cases, chronic pulpitis can form a fistula on the gum, oozing pus or foul-smelling fluid.
  • Tooth discoloration:Teeth may turn darker, gray or black due to pulp damage. pulp.
  • Multiply polyps may appear:In children or young people, pink fleshy tissue may be seen protruding from the cavity, which is a pulp polyp.

Similar to acute pulpitis, root canal treatment (pulp removal) is the most effective method to eliminate chronic inflammation. Delaying treatment can lead to more dangerous complications.

3. Pulp necrosis 

Pulp necrosis is the final and most dangerous level among thelevels of pulpitis. At this stage, the entire pulp tissue has completely died due to prolonged inflammation or severe damage.

Signs of recognition:

  • No longer feeling pain:This is one of the mistaken signs that the disease has been cured. When the pulp is dead, the nerves are no longer active, so the tooth can no longer feel pain.
  • Dark discoloration of teeth:Teeth can turn distinctly gray or black.
  • Bad breath:Due to strong bacterial activity in the necrotic root canal, causing an unpleasant odor.
  • Swollen gums, pus:Bacteria from the dead pulp can spread to the area around the tip of the tooth, causing inflammation, swollen gums, and pressure formation. pus (pus pocket) and fistula.
  • Loose teeth:In severe cases, the alveolar bone is destroyed, causing the tooth to become loose.

Dangerous complications:

Pulp necrosis, if not treated promptly, can lead to many dangerous complications such as:

  • Abscess around the tip of the tooth:Pustule pocket forms at the tip of the tooth root, causing severe pain and swelling, which can spread to the face.
  • Osteitis jaw:Infection spreads into the jawbone, causing pain, swelling, and even bone loss.
  • Sepsis:In extremely rare cases, bacteria can enter the bloodstream, causing a systemic infection.
  • Tooth loss:When the alveolar bone is severely destroyed, the tooth will no longer be able to hold and must be extracted.

Root canal treatment is mandatory at this stage. If the tooth has become too necrotic to be treated successfully or has caused serious complications, tooth extraction may be the final solution to protect overall health.

Prevent pulpitis at all levels

Brush your teeth properly

Brush your teeth at least twice a day with fluoride toothpaste, use a soft-bristled toothbrush and brush properly.

Chăm sóc răng miệng đung cách để phòng ngừa viêm tuỷ răng các cấp độ

Proper oral care to prevent pulpitis at all levels.

Use dental floss

Clean between teeth with dental floss or water flosser every day to remove plaque and leftover food.

Regular dental check-ups

Visit the dentist every 6 months for a general check-up, early detection and treatment of dental problems such as cavities and gingivitis before they progress to pulpitis.

Limit sweets and sour foods

Minimize consumption of foods and drinks high in sugar and acid to protect tooth enamel.

Protect teeth from injury

Avoid biting hard objects, use tooth protectors when playing sports (if necessary).

Early treat dental diseases

As soon as tooth decay or gingivitis is detected, treat promptly to avoid spreading and affecting the dental pulp.

 

For detailed examination and advice on your dental condition, also handle issues related to all levels pulpitis, make an appointment with the team of experienced experts at Lac Viet Intech Dental today! 

  • Hotline:0866.38.0033 (or 1900.6421)

 



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