Pulpitis is inflammation of the dental pulp, clinically categorized as reversible or irreversible based on the pulp's capacity to recover once the noxious stimulus is removed.
- Symptoms: short, sharp pain to cold or sweet; resolves when stimulus is removed. No lingering pain.
- Cause: incipient caries, recent restoration, exposed dentin, occlusal trauma.
- Treatment: remove the cause (caries, rough restoration); place a sedative dressing if needed. Monitor.
- Symptoms: spontaneous or lingering pain, often intensified by heat, relieved by cold in later stages. Pain on lying down. Referred pain.
- Cause: deep caries, repeated restorations, cracked tooth, trauma — anything that leads to sustained pulpal inflammation.
- Treatment: root canal therapy or extraction. Symptomatic irreversible pulpitis is an endodontic emergency.
- Thermal (Endo-Ice) — cold sensitivity elongates in irreversible pulpitis.
- Electric pulp test — supplementary; positive response indicates vital neural tissue.
- Percussion & palpation — adds periapical involvement information.
- Selective biting / tooth slooth — identifies cracks.
- Radiographs + CBCT for deep lesions, cracks, resorption.