Pulp Polyp

Pulp Polyp is a chronic inflammatory disease of the pulp. Pulp Polyp is an irreversible form of pulpitis. Pulp polyps are usually asymptomatic, patients might have mild-to-moderate tenderness on applying pressure on it during mastication. Localized bleeding may occur when the soft tissue is manipulated or traumatized.

Though the pulp has the ability to return to a healthy state once the noxious stimulus has been removed, but sometimes if the stimulus has stayed there for a very long time the pulp loses its ability to repair itself. This leads to the death of the involved tooth.

Pulp Polyp is seen in teeth which are either grossly decayed or teeth with their restorations lodged out or any trauma that leads to pulp exposure. This is because due to lack of intra-pulpal pressure in an open lesion pulp necrosis does not take place as would have occurred in a closed caries case.

Pulp Polyp

Tooth With Pulp Polyp.

The surface of pulp polyp lesion varies from pink and smooth to red and white and granular. Polyps typically enlarge to fill the entire cavity or whole of the pulp chamber of the tooth. Soft tissue may merge with the adjacent attached gingiva.

A pulp polyp is a single lesion, but multiple teeth may be affected. Teeth with open root stumps are the most susceptible. Extrusion of the opposing molar or tipping of the adjacent teeth with space loss may be observed when significant destruction of the crown occurs.

Cause of Pulp Polyp

The pulp polyp is the result of both mechanical irritation and bacterial invasion into the pulp of a tooth that has a significant crown destruction due to trauma or caries. The large exposure of pulpal tissue to the oral environment and bacterial invasion results in a chronic inflammatory response that stimulates an exuberant granulation tissue reaction.

The tissue reaction occurs because the pulp has a rich blood supply and favorable immune response that is more resistant to bacterial infection. Furthermore, because the tooth is open to the oral cavity, all the inflammatory fluid drains in the mouth. Tissue necrosis with destruction of the micro-circulation that usually accompanies irreversible pulpitis does not occur in part because of this lack of significant intra-pulpal pressure.

Causes of a pulp polyp include the following:

  • Dental caries in young tooth where significant loss of tooth is seen.
  • Fractured tooth, causing trauma to the pulpal tissues.
  • Mechanical irritation from chewing, and bacterial irritation provides stimulus.
Pulp Polyp

Pulp Polyp in an older individual, showing low degree of swelling, compared to the selling caused in a younger individual.

Symptoms of Pulp Polyp

Pulp Polyp is mostly pain free. There may be a little tenderness on biting as it will apply pressure on the swollen pulpal tissue. There may be some occasional bleeding from the swelling. There are no major symptoms caused by pulp polyp.

The swelling caused by pulp polyp decreases as the age of the affected individual increases.

Diagnosis of Pulp Polyp

Diagnosis of pulp poly is done by performing adjunctive and vitality  tests, including response to percussion, thermal stimuli, and electric pulp testing.In addition, these tests help to differentiate a true pulp polyp from hyperplastic gingivitis that is overlying a cavitation from a non-vital tooth. Points to be noted are :

  • Radiographs show a large, open cavity with direct access to the pulp chamber.
  • Response is seen on electric pulp testing too.
Pulp Polyp

Pulp Polyp – Radiograph showing radio-translucency in continuation with the pulp chamber of the affected tooth.

Expected Duration of Pulp Polyp

Pulp polyp is an irreversible form of pulpitis, so it’ll never heal on its own. Sometimes pulp polyp might go into a state of stasis, during this it will stop growing in size but it stay there till its not treated.

Pulp Polyp

Pulp Polyp – If you notice swelling like this call your dentist.

Treatment of Pulp Polyp

Pulp Polyp is treated by the removal of the swollen pulpal tissue. When the pulpal mass is removed, bleeding can be controlled by application of pressure. If the tooth structure is preservable Root Canal Treatment is performed , if not extraction of the involved tooth is done and prosthetics are installed in it place.

When to Call a Professional

If you notice a pink or red or white or any soft tissue swelling coming out of the tooth surface or you feel any tenderness while eating, make sure you book an appointment with your dentist.

Prognosis of Pulp Polyp

Excellent prognosis is seen in case of pulp polyp after the treatment.