A broken tooth with exposed pulp can be a serious dental emergency that causes intense discomfort and puts your oral health at risk. When the protective layers of your tooth, the enamel and dentin, are damaged, the delicate pulp tissue inside becomes vulnerable. This pulp contains nerves, blood vessels, and connective tissue that keep the tooth alive.
Understanding what happens when the pulp is exposed, how to recognise the symptoms, and what treatment options exist is important for protecting your natural teeth and preventing further complications.
What Happens When the Tooth Pulp Is Exposed
Inside every tooth is a soft area called the tooth pulp, which lies beneath the enamel and dentin layers. The pulp chamber contains blood vessels, immune cells, and nerves that help maintain the tooth’s vitality.
When a broken tooth exposes the pulp, the protective barrier is lost, allowing bacteria to enter the pulp chamber. This usually results in inflammation or infection within the surrounding tissues, leading to severe pain, sensitivity, and swelling.
An exposed pulp is often the result of one of the following:
- A cracked tooth or fractured cusp from biting hard objects.
- Sports injuries or accidents that damage the tooth’s structure.
- Deep cavities caused by untreated tooth decay.
- Wear and tear that weakens tooth enamel over time.
The tooth’s chewing surface breaks, or when a crack extends near the gum line, the pulp may become visible or exposed to air, food particles, and bacteria. If not treated in time, this may gradually result in irreversible pulpitis, a painful infection that could require root canal treatment or even tooth extraction.
Signs and Symptoms of Exposed Tooth Pulp
Because the pulp contains nerves and soft tissues, even minor exposure can cause strong sensations or erratic pain. You may notice:
- Sharp pain when biting or chewing.
- Sensitivity to sweet foods or hot and cold temperatures.
- Pain that lingers after eating or drinking.
- Discomfort that worsens when lying down.
- Swelling or redness near the affected tooth.
In severe cases, the pain may become constant, and you might see visible signs of pulp exposure, such as a small red or pink spot inside the damaged tooth.
Why Exposed Pulp Is a Dental Emergency
When the pulp inside the tooth is open to bacteria, infection can spread quickly. The body’s natural response sends immune cells to fight the infection, leading to inflammation and pressure inside the pulp chamber. Because the pulp is enclosed in hard tissue, it has limited space to swell, which intensifies pain.
If the condition progresses, the infection can spread to the surrounding bone or gum tissues. Over time, this can cause an abscess, bone loss, or even tooth loss.
Prompt attention from a dentist is essential, as early care can often make the difference between saving or losing the tooth.
Common Causes of Tooth Pulp Exposure
Several everyday factors and injuries can lead to tooth pulp exposure.
Dental Injuries
Falls, accidents, or sports injuries can fracture a tooth, exposing the inner layers. In split tooth cases, the crack divides the tooth into distinct segments, making it difficult to restore.
Cracked Tooth Syndrome
A cracked tooth syndrome can develop from tiny cracks that gradually deepen with time. These hairline fractures might not cause symptoms at first, but can expose the pulp if the crack extends toward the root.
Deep Cavities and Tooth Decay
When tooth enamel breaks down from decay, bacteria move deeper into the tooth until they reach the pulp tissue. Without treatment, this can result in irreversible pulpitis and infection.
Worn Enamel and Teeth Grinding
Chronic teeth grinding (bruxism) can wear away enamel and dentin, exposing the inner layers. The chewing surface becomes vulnerable to cracking or breaking.
Dental Procedures or Restorations
In some cases, large fillings or repeated dental work can thin the enamel and irritate the pulp, making it more prone to exposure.
Diagnosing an Exposed Tooth Pulp
A proper diagnosis requires a clinical exam and imaging. Dentists use dental X-rays to assess the extent of damage and determine if infection has spread beyond the pulp. In some cases, dental X-rays may reveal underlying vertical root fractures or signs of inflammation in the surrounding tissues.
The dentist will test the tooth’s vitality to see if the pulp inside is still alive. If the nerve still responds to stimuli, the tooth may be saved through less invasive procedures such as pulp capping. However, if the pulp is infected, root canal therapy may be necessary.
Treatment Options for Exposed Tooth Pulp
The right treatment options depend on the extent of the injury and the tooth’s health. The main goal is to protect the pulp, prevent infection, and restore function.
Pulp Capping
If the exposure is small and the pulp tissue is still healthy, your dentist may perform a pulp capping procedure. A protective material is placed over the exposed pulp to seal it and help it heal. This treatment can preserve the tooth’s vitality and prevent infection.
There are two main types of pulp capping:
- Direct pulp capping: Applied when the pulp is exposed but not infected.
- Indirect pulp capping: Used when decay is close to the pulp but doesn’t fully expose it.
Both methods aim to protect the pulp and support the tooth’s healing and long-term function.
Root Canal Treatment
In cases of infection or irreversible pulpitis, a root canal becomes necessary. This root canal treatment involves removing the damaged pulp, cleaning and disinfecting the root canals, and sealing them with a safe filling material. Lastly, a dental crown is fitted onto the tooth to rebuild its strength and function.
This procedure helps relieve pain, eliminate bacteria, and maintain your natural teeth without needing tooth removal.
Tooth Extraction
If the crack goes deep beneath the gum line or the tooth is significantly damaged, extraction may be the only suitable option. After extraction, dental implants can replace the missing tooth and support the surrounding bone to prevent shifting.
Dental Crown Placement
A dental crown can protect and restore a damaged tooth after pulp therapy. It covers the chewing surface, helping to prevent further complications and allowing you to eat comfortably again.
Reversible vs Irreversible Pulpitis
Understanding the difference between reversible pulpitis and irreversible pulpitis is important for choosing the right treatment.
- Reversible pulpitis: The pulp is inflamed but can heal with prompt care, such as a filling or pulp capping. The tooth remains alive, and symptoms are usually mild.
- Irreversible pulpitis: The pulp is severely inflamed or infected, causing severe pain and persistent sensitivity. It usually requires root canal therapy or tooth extraction to stop the infection.
Knowing which type of pulpitis is present helps the dentist determine the most effective way to save the tooth.
How to Care for an Exposed Tooth Before Treatment
If you experience a broken tooth with exposed pulp, act quickly and seek professional help. While waiting for treatment:
- Avoid chewing on the affected side.
- Gently rinse your mouth with warm salt water to clear away any debris.
- Avoid sweet foods and extreme temperatures.
- Use over-the-counter pain relief as advised by your dentist.
- Keep your mouth clean and practise good oral hygiene by brushing gently and flossing regularly.
Do not attempt home natural remedies, as they can irritate the soft tissues or introduce bacteria into the pulp chamber.
Preventing Pulp Exposure and Further Damage
Keeping up good oral hygiene habits and regular dental check-ups plays an important role in preventing pulp exposure. Follow these prevention tips:
- Brush your teeth morning and night with fluoride toothpaste and floss each day.
- Wear a mouthguard during sports to prevent injuries or grinding at night.
- Refrain from biting on hard objects such as ice or pen tips.
- Treat deep cavities early to avoid pulp exposure.
- Seek care for any minor cracks or discomfort before they worsen.
- Practise early detection through routine visits, as early diagnosis helps protect your overall oral health.
Consistent care at a dental clinic helps catch minor issues before they turn into emergencies.
The Role of Early Intervention
When detected early, pulp exposure can often be managed conservatively. Procedures like pulp capping or root canal therapy can restore the tooth’s vitality and prevent further complications. Ignoring the signs can result in infection, swelling, or complete tooth loss.
Early intervention not only preserves natural teeth but also supports long-term oral health and overall well-being.
Final Thoughts
A broken tooth with exposed pulp is more than just a cosmetic issue. It is a threat to your tooth’s health and overall oral health. Recognising the warning signs and acting early can help you prevent severe pain, infection, and possible tooth loss.
If you’re concerned about ongoing pain or sensitivity from an exposed tooth pulp, book a consultation or call (08) 7078 8263.
Note: Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.
Resources
Cherney, K., McLean, A. & Archibald, J. (2025). ‘10 Ways to Keep Your Teeth Healthy’. San Francisco, CA, 13 May. San Francisco, CA: Healthline Media. https://www.healthline.com/health/dental-and-oral-health/best-practices-for-healthy-teeth
Mayo Clinic Staff. (2025). ‘Root Canal Treatment’. Rochester, MN, 5 September. Rochester, MN: Mayo Foundation for Medical Education and Research. https://www.mayoclinic.org/diseases-conditions/tooth-abscess/in-depth/root-canal/art-20585454
Cleveland Clinic Staff. (2023). ‘Cavities’. Cleveland, OH, 27 March. Cleveland, OH: Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/10946-cavities