At the center of each of your teeth is a structure of soft tissue known as the pulp. Ordinarily the pulp is protected by the surrounding enamel and cementum. But if this shield is thin or damaged, the pulp may be exposed to external irritants. When that happens, it will become sensitive or inflamed, and may even die.

The most common sources of pulp damage include tooth decay, trauma (whether through accident or violence), periodontal disease and abrasion or erosion of the tooth surfaces. Treatment for these issues is known as endodontics, and it can be performed by general dentists as well as endodontic specialists.

Here are some of the most common types of pulp damage and how to treat them:

  • Hypersensitivity: Sensitive teeth are caused by exposed dentin, which causes a sharp, stabbing pain when the teeth exposed to excessive hot, cold or acidic food or drink. The condition can generally be alleviated without difficulty. Your dentist will either seek to seal your teeth (with chemicals or composite materials) or densensitize your nerves with special chemicals.
  • Pulpitis: If your dentin is extensively exposed, your nerves may become inflamed, a condition known as pulpitis. The most common symptom is increased sensitivity that causes a lasting, throbbing ache (rather than a short, stabbing pain). Pulpitis is also often accompanied by a bacterial infection, and can be reversible, in which case it eventually heals with conservative treatment, or irreversible, which usually requires root canal therapy.
  • Bacterial infections: Bacterial infections often accompany pulpitis, especially if the condition is caused by tooth decay. Symptoms include pain and inflammation—a classic “toothache”—and root canal therapy is the most common treatment, though your dentist may attempt more conservative techniques if the damage is minimal. During a root canal, your dentist will remove the pulp of the affected tooth, then fill and seal the canals with an inert material. Thanks to recent advances in surgical technology and equipment, the pain is usually minimal.