Every day people go to the dentist with aching pain in the elements of the dental system. The syndrome can develop due to damage to enamel, dentin, and pulp. Based on the nature of the localization, pain sensations can be pulsating, aching, shooting in nature, temporary or long-lasting. Most often, pain is observed in the evening and at night. In this case, you must immediately contact a specialized specialist for diagnosis and prescribing appropriate therapy, followed by removal of the tooth nerve. Self-treatment at home can aggravate the situation and contribute to the development of serious complications.
Dental nerve - what is it?
In fact, the nerve in the tooth is the pulp. It is surrounded by dentin, which covers the enamel on top. This part of the tooth is responsible for nourishing all other tissues, as well as for sensory perception. Therefore, after its removal, the crown usually fades, acquires a grayish tint, and becomes fragile and brittle. Such a tooth is called dead.
The pulp is a bundle of blood vessels and nerves of the tooth.
As soon as carious processes penetrate deeper into the dentin and reach the pulp, the person begins to experience severe piercing pain. In this case, doctors usually make a diagnosis of pulpitis. But this disease can also be traumatic. With a strong blow, the pulp is damaged and becomes inflamed. If treatment is not started in time, the nerve will have to be partially or even completely amputated. This is necessary to prevent further spread of the inflammatory process and the development of complications, including periodontitis.
Procedure
- Grasp the tooth, cover it with a sterile bandage, and pull. Keep shaking it. You can use forceps, pliers, tweezers.
- Do not squeeze the tooth too hard to prevent it from cracking.
- From time to time, try to pull it firmly, but without jerking, so as not to break off part of the root and cause an inflammatory process.
- Act smoothly, rocking the tooth and periodically trying to pull it out. Jerking is unacceptable, as you can damage the gum or break the root. Then it is no longer possible to do without the help of a surgeon.
After successful extraction:
- Place a sterile swab on the hole for half an hour.
- Remove it without disturbing the formed clot.
- Do not eat for three hours.
- Monitor the condition of the gums in the injured area, rinse your mouth with vodka, potassium permanganate solution, hydrogen peroxide or other disinfectant.
- You can use a decoction of oak bark to speed up healing and reduce pain.
To remove a tooth root you need to prepare:
- Spitting container;
- Antiseptics;
- Pain reliever;
- Gauze Swabs and pads;
- Mirror.
These tips should not be resorted to if it is possible to turn to a professional, since root extraction is a rather serious and risky operation.
In what cases is nerve removal indicated?
With pulpitis, the causative tooth reacts sharply to any mechanical and temperature stimuli. If the neurovascular bundle is already severely damaged, there is no point in trying to stop the inflammatory process, because the risk of relapse is too high. In such a situation, the doctor prescribes removal of the nerve - depulpation. Thus, among the main indications for this procedure, experts in the field of endodontics identify the following pathological conditions:
- advanced caries and pulpitis: when the lesion destroys enamel and dentin and reaches the pulp, it is necessary to either urgently stop the inflammation or remove the affected tissue. The first option is possible only in the early stages of pulpitis, but in practice it is more often necessary to partially or completely amputate the neurovascular bundle,
- complication after unsuccessful treatment in dentistry: in the process of preparing a too large carious cavity, there is always a risk of accidentally injuring the pulp. In such a situation, to correct the error, you also have to remove it partially or completely,
- prosthetics: to install fixed bridges and dentures, it may be necessary to depulpate the abutment teeth,
- mechanical injuries: the pulp can be damaged and inflamed also due to a strong blow. Large chips and cracks in the enamel often lead to similar consequences.
Removal of the nerve is indicated in the treatment of pulpitis
“They removed the nerve from my tooth, but that was a long time ago. Back then, a special medicine was put inside, and something like a temporary filling was placed on top. After 3-4 days you come back for an appointment, and the doctor is already pulling out the dead nerve. I remember while I was waiting for the next appointment, it was unpleasant, the tooth hurt, but it seemed like it should be. I heard that now this procedure is easier, they can do everything in one visit.”
Maxim_Volt, from correspondence on the forum www.32top.ru
Piercing pain in the tooth, which becomes especially unbearable at night, most often indicates the development of pulpitis. However, when the pathological process becomes chronic, acute symptoms may disappear completely. In this case, only a professional doctor can make a correct diagnosis in time. This is one of the reasons why it is so important to have a routine dental checkup every six months.
How to kill the pulp in dentistry
As for how to kill a nerve in dentistry, specialists for this purpose use two methods of depulpation - vital and devital. The first option involves amputation of the inflamed vascular bundle in one visit, under anesthesia. With the devitalizing method, the removal is carried out in two steps: at the first appointment, the doctor puts a devitalizing paste into the tooth and places a temporary filling on top, and at the second, he amputates the already dead pulp.
Quite aggressive arsenic compounds are used for killing. But today they are gradually being replaced by less toxic formaldehyde pastes. Below we will take a closer look at exactly what medications are used to kill the nerve.
Devitalizing pastes with arsenic: “Devit-Ars” and “Kaustinerv Rapid”
The basis of the drug "Devit-Ars" is arsenic anhydride. It leads to the gradual death of soft tissues and fairly rapid death of the pulp. To make this process painless for the patient, the composition also contains lidocaine.
The photo shows arsenic paste
It should be noted that the process of necrosis of living tissue requires strict control by a doctor, otherwise the consequences for the body can be very serious. It is very important to provide reliable protection against infection during this time. For this purpose, antiseptics are also added to the Devit-Ars paste - eugenol, chlorophenol and metacresol. As a rule, killing with this drug occurs literally within 24 hours1. In rare cases, the process takes a little longer, but usually no more than 2 days.
"Caustinerv Rapid" is another popular devitalizing drug in dentistry based on the same active substance. The composition also contains lidocaine, phenol, hydrochloric ephedrine and menthol. The devitalization process takes on average 2-3 days.
Arsenic-free pastes - formaldehyde
One of the most popular drugs in this category is Devit. It is based on paraformaldehyde, the action of which is aimed simultaneously at killing the pulp and antiseptic treatment of tissues. Lidocaine acts as an anesthetic component, and creosote is responsible for the antimicrobial properties.
Paste without the presence of arsenic can be used
To perform its immediate task, this formaldehyde paste requires much more time - up to 10 days. On the other hand, this is a much more gentle and safe method that poses virtually no threat to the body. Another important advantage of this type of devitalizing agents is the deep sterilization of the pulp chamber, which often makes it possible to preserve tissue at least partially.
Important! After arsenic paste, the doctor must carry out a very thorough treatment of the canals and make sure that there are no traces of a toxic substance there. When using formaldehyde compounds, this step can be skipped.
After 2 to 10 days, depending on the type of composition used, the patient needs to visit the doctor again to complete the treatment. He will remove the temporary filling, remove dead tissue, treat the canals and seal them. A permanent filling will be placed on top and sent for a control x-ray.
Answer-question section
Is it painful to perform depulpation?
In dentistry, powerful local anesthetics are used that completely block discomfort during the intervention. Severe pain may be felt if the drug is not suitable for the patient or was administered in the wrong dosage. Without pain relief, the process of treating a carious cavity is very painful.
Why do gums hurt after depulpation?
During the procedure, nerve endings are damaged. Because of this, pain persists for 2-3 days after the intervention. If the doctor performed all the manipulations correctly, the intensity of discomfort decreases, as a rule, by 2-3 days.
Is it possible to perform the procedure for free?
In public medical institutions, the procedure for removing the dental nerve is provided free of charge under the compulsory medical insurance policy. A separate additional payment for the administration of pain medication is possible.
How to relieve pain at home yourself
It is worth taking a closer look at the question of how you can calm the nerve yourself before visiting a specialist. You need to understand that such remedies are only needed to mask the symptoms, but they will not help to quickly kill the pulp and relieve you of pain forever. Therefore, you will have to visit the dentist in any case. And if it is not possible to do this urgently, the following traditional medicine recipes will help to relieve the pain and discomfort a little:
- Soda-salt solution is one of the most popular and effective home remedies for relieving acute toothache. A teaspoon of salt and soda should be diluted in a glass of boiled water at room temperature and then used for rinsing the mouth,
You can use a solution of soda and salt - a solution based on 3% hydrogen peroxide also helps reduce the intensity of discomfort. Peroxide should be diluted in warm water in a ratio of 2 to 1, then soak a cotton swab in the resulting solution and apply it to the sore tooth,
- onion peels will help reduce pain and disinfect tissues. To do this, pour 500 ml of boiling water over a small handful of husks and leave for a while on low heat. Strain the finished broth, let it sit for 2-3 hours and then use it for rinsing,
- a mixture of garlic and salt will help reduce inflammation somewhat. To do this, it is placed in an open carious cavity,
- Clove essential oil has pronounced antiseptic and anti-inflammatory properties. It is enough to drop a couple of drops on a cotton swab and cover the painful area with it,
- herbal decoctions of chamomile, mint, lemon balm, thyme, sage and oak bark. You can prepare a decoction of herbal tea or use one type of dried flower.
Herbal decoctions can be used at home
Remember that any attempts to kill the exposed nerve yourself will only lead to a worsening of the condition and the development of dangerous complications. If your tooth hurts badly, try to see a specialist as soon as possible.
Is it possible to kill a nerve yourself using traditional methods?
Many people are interested in the question of whether it is possible to kill the pulp on their own at home and what folk remedies are best to use for this. The answer will be categorical: such serious dental procedures should be performed by a professional doctor, and nothing else. Otherwise, you risk only aggravating the situation and provoking the development of serious complications.
Therefore, below, for informational purposes only, are the old methods that were previously popularly used to kill a tooth. Here's what they used to kill the nerve, except for arsenic:
- vinegar - moisten a piece of cotton wool in vinegar essence and apply to the causative tooth. Great care should be taken as the essence quickly corrodes enamel and dentin,
- gunpowder - place the substance into the carious cavity, but under no circumstances swallow it, as this can lead to serious poisoning,
- iodine – moisten a piece of cotton wool with iodine and apply it to the hole. You just have to prepare for the fact that it will hurt very, very badly,
Iodine is also used in folk medicine - zinc - burn a piece of newspaper with black ink, collect the ashes on a cotton swab and place it as close to the nerve as possible, leaving it there for about 12 hours,
- arsenic - place a pea of a toxic substance into a cavity in a tooth. It is very easy to fail to calculate the dosage, which can result in serious poisoning of the body and even death.
Under no circumstances should you try to use these methods on yourself. Contact your dentist and undergo the appropriate procedure under the supervision of an experienced specialist. Independent attempts are fraught with dangerous complications.
What complications can there be from home methods?
Even a doctor during depulpation can make a mistake that will lead to undesirable consequences. What can we say about independent attempts to kill the pulp at home, without following any rules of asepsis and antiseptics. Among the possible negative consequences of such arrogance, experts note nerve separation, severe hemorrhage due to vascular injury, as well as the spread of inflammation to nearby tissues. Other possible problems include:
- allergic reaction to the substances used,
- injury to healthy tissues,
- burn of the mucous membrane,
- loss of taste sensitivity,
- infection and sepsis.
When using home methods, a burn may occur.
Most often, after trying to kill the pulp on their own using traditional methods, patients are faced with a severe burn of the mucous membrane. In other cases, the pulp is burned with preservation but serious damage to the nerve.
Precautionary measures
To prevent folk remedies for toothache from harming your health, you should follow several basic rules:
- do not swallow mouthwash;
- avoid contact of antiseptic solutions with eyes;
- do not keep medications in your mouth for too long;
- follow the dosage of medications indicated in the instructions.
The effectiveness of home remedies for pulpitis is questionable, since a person himself will not be able to clean and fill the dental canals. Among the complications that arise during treatment at home, the following should be noted:
- burn of mucous structures;
- inflammation of the soft tissues of the mouth;
- poisoning.
What is strictly forbidden to do
There are also several strict restrictions and prohibitions that must be observed to avoid unwanted consequences. Here are the main ones:
- you can’t heat the causal area - no hot compresses, which only intensify the pain and provoke the spread of inflammation,
- you should not take a horizontal position - this will increase blood flow to the painful area, which will make the unpleasant sensations even more intense,
- Under no circumstances should you use needles - some try to pick out the cavity themselves, but this is strictly prohibited. Otherwise, you can provoke severe bleeding and even infection.
In no case should you attach a heating pad to an inflamed nerve.
Killing and removing a nerve from a tooth, even in dentistry, is considered a serious procedure that requires the proper experience and dexterity from a specialist. Therefore, in case of inflammation of the pulp, the help of a qualified specialist – an endodontist – is required. This is not a case where you can do it on your own. Don't risk your health.
1According to information at the office. manufacturer's website: vladmiva.ru.
Complications when keeping the product in the tooth for a long time
Since arsenic is toxic, leaving the medicine for more than seven days leads to the following consequences:
- The occurrence of inflammation in the soft tissues of the tooth.
- Necrosis of the incisive bone.
- Pulp swelling.
- Spread of necrosis to adjacent teeth.
The patient must follow the advice of a specialist and obtain the drug in a timely manner. The slightest delay ends in intoxication of the entire body.