Pulp polyp - everything you need to know

May 07, 2021

  

The pulp represents the core of the tooth that comprises of all the nerves and blood vessels. Any sense perceived by the tooth is because of the pulp. A polyp is an abnormal growth from the lining of a tissue. A pulp polyp is thus an abnormal growth arising from the pulp as a result of inflammation.

The inflammation of pulp can be because of many reasons. It is important to note that the pulp is healthy and rich in blood supply in these patients. A long-standing decayed tooth, a fractured tooth or an exposed tooth that is not covered by a filling (restoration) are the main factors that contribute to the formation of a pulp polyp. In the reasons mentioned above, the pulp is subject to prolonged inflammation. The inflammation is mainly because of the fact that the healthy pulp tissue is resisting the irritation caused by the causative factors. In this battle between the pulp and the irritant, a granulation tissue is formed. This is a tissue that is formed when the inflammation causes the tissue (pulp) to increase in size and swell. Thus, pulp polyp gets its another name, chronic hyperplastic pulpitis. Chronic indicates a longer duration of inflammation, hyperplastic means increase in the size of the tissue and pulpitis refers to inflammation of the pulp.

A pulp polyp can vary in pain intensity. It has usually a mild to moderate pain response and is more often seen in middle-aged patients. The pulp polyp is usually seen in the back teeth. These teeth are the ones that help us in essentially breaking down food biting forces. When these forces act on the pulp, the inflammation can aggravate. Clinically, a pulp polyp is seen as a round red or pink mass that can be seen popping out of the open tooth structure. A dentist can lift it for inspection and also ensure that the mass is related to the tooth's pulp and not the surrounding gingiva (gums).

Before beginning with the treatment, the dentist will take a radiograph (x-ray) to study the effect of the polyp in the associated ligaments and roots of the tooth. At times, the tooth might have an associated abscess (infectious fluid-filled cavity near the roots of the tooth) or might have the infection spread to the ligament that binds the tooth in the socket of the jaw. Managing a tooth with pulp polyp depends on the amount of inflammation, associated infection and the total tooth structure available.

When there is sufficient tooth structure available, the tooth can be restored after carrying out a root canal treatment. This involved disinfecting the roots of the tooth, filling them with appropriate root-filling material, followed by placement of a permanent restorative material. A post and core procedure can also be carried out in order to make the tooth sturdy again. This procedure involved filling the tooth with a 'post' that is placed within the roots and a 'core' that is attached to the post and makes up for the crown of the tooth. In some cases when the tissues surrounding the tooth are affected, crown lengthening procedures might be needed along with the root canal treatment. When there is not enough tooth structure available, the tooth must be removed and replaced by a prosthesis. The artificial prosthesis can be an implant or a denture (fixed or removable) or a bridge, depending on the health of the underlying bone.

After the needed treatment is carried out, the patient is advised not to chew from the side where the procedure was carried out for two days. An antibiotic and analgesic regime is prescribed in order to relieve pain and reduce the infective load. The usage of a 0.2% chlorhexidine mouthwash, twice a day, is also advised to the patient. The patient is further instructed not to brush vigorously in the region of the treated tootj for a few days. The final procedure is to cover or cap the treated tooth to reinforce its strength.

Pulp polyp can be symptomless in most cases and thus is often unnoticed. The patient ususlly visits the dentist when there is mild discomfort experienced in the affected region. It is at times discovered in dental visits during a routine check-up. Thus, the treatment of a pulp polyp once diagnosed must not be delayed as the chronic inflammation needs to be ceased, so that it does not spread to adjacent tissues.

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