Pulp (tooth) - Clinical Significance

Clinical Significance

Pulp acts as a security and alarm system for a tooth. A little decay in tooth structure not extending to dentine may not alarm the pulp but as the dentine gets exposed, either due to dental caries or trauma, sensitivity starts. The dentinal tubules pass the stimulus to odontoblastic layer of the pulp which in turns trigers the response. This mainly responds to cold. At this stage simple restorations can be performed for treatment. As the decay progresses near the pulp the response also magnifies and sensation to hot diet as well as cold gets louder. At this stage indirect pulp capping might work for treatment but at times it is impossible to clinically diagnose the extent of decay, pulpitis may elicit at this stage. Softened dentine by dental decay progressing to pulp may get fractured during mastication (chewing food) causing direct trauma to the pulp hence eliciting pulpitis. An inflammation of a pulp is known as pulpitis. Pulpitis can be extremely painful and in serious cases calls for root canal therapy. Traumatised pulp starts inflammatory response but due to hard and closed surrounding of the pulp lots of pressure builds inside pulp chamber thus compressing the nerve fibres and eliciting extreme pain (Acute Pulpitis). At this stage the death of pulp starts which eventually progresses to periapical abscess formation (chronic Pulpitis).