Paradoxically, the very dental treatment designed to
repair the tooth may do harm to the dental pulp. Cavity
preparation is a common cause of pulp inflammation.
High-speed cutting is superior to low-speed even when
air and water coolant are used but some degree of pulp
irritation will still occur. Heat, cutting depth (within
0.5mm of the pulp) and dehydration cause damage to
the pulp. Pin insertion can crack dentine and predispose
the tooth to bacterial infection. Large restorations may
cause cracks in teeth when under load. Pressure from
condensing restorative materials may intensify pulp
responses induced by the cutting procedure. Acid
etching, a common procedure in adhesive dentistry,
removes the smear layer and this may allow bacteria to
enter the dentinal tubules.
Orthodontic movement,
periodontal curettage, and prosthodontic manipulation
may also cause pulp inflammation.
Medical procedures, such as rhinoplasty, may
damage pulps adjacent to the surgical area or they may
interfere with the blood supply to the pulp. The
Caldwell-Luc surgical technique, which involves
removal of the lining of the maxillary antrum, may also
cause pulp inflammation, necrosis or anaesthesia.