Caries Pulpitis Pulpal necrosis
Acute periapical Chronic periapical
Enamel Dentine Reversible Irreversible
periodontitis periodontitis
Reason No pain The dentinal tubules are As the caries becomes more The microorganisms in the root canal, and their If
for pain able to transport the extensive, the pulp becomes toxins can emanate from the apex of the root, parti
bacterial toxins to the pulp, severely inflamed and leading to an inflammatory response in the pus
triggering an acute swollen, such that pulpal periapical tissue, which eventually leads to loss of absc
inflammatory response. will
ischaemia occurs. bone around the apex of the tooth
via t
Initial surface Can be cavitated. Short-lasting (secs), sharp, well- Spontaneous or stimulated poorly Severe spontaneous or Sometimes asymptomatic. Cons
Presentation Symptoms of pulpitis localised pain that lasts mins/hours. (hou
demineralisation. localised pain that disappears stimulated well-localised May have mild pain on
may be present, on removal of stimulus and Stimulated pain present with delay. biting. Spon
No cavity pain which lasts mins/
depending on depth doesn’t need analgesia. Pain history is a few days. swal
hours. May have sinus tract
Pain present for weeks/ months. Analgesia has some effect. Pain
of caries Pain present for May have had pain in the
Pain is caused by cold/ hot food or Pain
Stimulated by hot, cold and days/weeks. past, but no longer
drinks, sweet food, fresh air. Cold Intra
sweet stimuli sensitive to hot, cold.
may relieve pain May be tender to bite Syste
The
Special Radiographs Thermal tests Thermal tests Thermal tests Thermal tests
- No
investigations - coronal radiolucency -Pain appears upon stimulation and - Pain appears with delay and lingers - No response - No response
Perc
disappears upon stimulus removal (2-3mins) after removal. Percussion Percussion
-Ten
Electric tests Electric tests -Tender - Not tender
Palp
-Lower levels of electric current -Lower levels of electric current Palpation Radiographs
-Ten
trigger pain compared to control trigger pain compared to control -Tender - Caries or filling close to
Radi
Percussion Percussion Radiographs the pulp
- Car
-No tenderness -little tenderness sometimes - Caries or filling close to - Well-defined periapical
-Wel
Radiographs Radiographs the pulp radiolucency
radio
- Caries or filling close to the pulp - Caries or filling close to the pulp - Widening of the PDL Acute exacerbation
Cavi
- No periapical radiolucency - No Periapical radiolucency -No periapical radiolucency Combined features with
-Not
Cavity prep without anaesthesia -Widening of PDL acute
very
-The patient feels pain as soon as Cavity prep without anaesthesia
you reach the dentine and the pain -The patient feels pain as soon as
disappears as soon as you stop you reach the dentine and the pain
drilling continues (2-3mins) after drilling
OHI Restore Restore RCT then restore RCT then restore RCT then restore Dra
Treatment Prevention: RC
Monitor Monitor Monitor Monitor
topical fluoride Ext
Acute periapical Chronic periapical
Enamel Dentine Reversible Irreversible
periodontitis periodontitis
Reason No pain The dentinal tubules are As the caries becomes more The microorganisms in the root canal, and their If
for pain able to transport the extensive, the pulp becomes toxins can emanate from the apex of the root, parti
bacterial toxins to the pulp, severely inflamed and leading to an inflammatory response in the pus
triggering an acute swollen, such that pulpal periapical tissue, which eventually leads to loss of absc
inflammatory response. will
ischaemia occurs. bone around the apex of the tooth
via t
Initial surface Can be cavitated. Short-lasting (secs), sharp, well- Spontaneous or stimulated poorly Severe spontaneous or Sometimes asymptomatic. Cons
Presentation Symptoms of pulpitis localised pain that lasts mins/hours. (hou
demineralisation. localised pain that disappears stimulated well-localised May have mild pain on
may be present, on removal of stimulus and Stimulated pain present with delay. biting. Spon
No cavity pain which lasts mins/
depending on depth doesn’t need analgesia. Pain history is a few days. swal
hours. May have sinus tract
Pain present for weeks/ months. Analgesia has some effect. Pain
of caries Pain present for May have had pain in the
Pain is caused by cold/ hot food or Pain
Stimulated by hot, cold and days/weeks. past, but no longer
drinks, sweet food, fresh air. Cold Intra
sweet stimuli sensitive to hot, cold.
may relieve pain May be tender to bite Syste
The
Special Radiographs Thermal tests Thermal tests Thermal tests Thermal tests
- No
investigations - coronal radiolucency -Pain appears upon stimulation and - Pain appears with delay and lingers - No response - No response
Perc
disappears upon stimulus removal (2-3mins) after removal. Percussion Percussion
-Ten
Electric tests Electric tests -Tender - Not tender
Palp
-Lower levels of electric current -Lower levels of electric current Palpation Radiographs
-Ten
trigger pain compared to control trigger pain compared to control -Tender - Caries or filling close to
Radi
Percussion Percussion Radiographs the pulp
- Car
-No tenderness -little tenderness sometimes - Caries or filling close to - Well-defined periapical
-Wel
Radiographs Radiographs the pulp radiolucency
radio
- Caries or filling close to the pulp - Caries or filling close to the pulp - Widening of the PDL Acute exacerbation
Cavi
- No periapical radiolucency - No Periapical radiolucency -No periapical radiolucency Combined features with
-Not
Cavity prep without anaesthesia -Widening of PDL acute
very
-The patient feels pain as soon as Cavity prep without anaesthesia
you reach the dentine and the pain -The patient feels pain as soon as
disappears as soon as you stop you reach the dentine and the pain
drilling continues (2-3mins) after drilling
OHI Restore Restore RCT then restore RCT then restore RCT then restore Dra
Treatment Prevention: RC
Monitor Monitor Monitor Monitor
topical fluoride Ext
