| Feature / Symptom | Clinically Normal Pulp | Reversible Pulpitis | Irreversible Pulpitis | Pulp Necrosis / Infected RCS |
|---|
| Diagnostic Basis | N/A (Healthy) | Based on severity & duration of symptoms. | Based on severity & duration of symptoms. | Based on diagnosing apical periodontitis (pulp sensibility tests, periapical status, radiographs). |
| Typical Stages & Symptoms | No symptoms or signs. |
- Chronic: Few & occasional symptoms - short, sharp pain to heat, cold.
- Acute: Regular short, sharp pain with heat, cold.
|
- Chronic: Occasional sharp & lingering pain with heat, cold.
- Acute: Severe sharp & lingering pain with heat, cold; Spontaneous; Worse lying down; Wakes patient. May have apical periodontitis.
|
- Pulp Necrosis: Mixed symptoms/signs of pulpal & necrosis.
- Pulpless Infected RCS: Pulpless with infection.
- Pulpless Necrosis: No pulp symptoms.
- (All eventually lead to acute apical periodontitis)
|
| Nature of Pain | None | Sharp, mild–mod. | Sharp & aching | Dull ache, throbbing |
| Thermal Sensitivity | Responds normally | Extreme temp's | Mild changes | - |
| Duration of Pain | N/A | Short (sec's–min's) | Lingers (* > 5–10 min's) | On + off–Continuous |
| Biting Pain | - | +/- | + | + |
| Percussion | - | +/- | + | + |
| Spontaneous Pain | - | - | +/- | + |
| Wakes at Night | - | - | +/- | +/- |
| Worse Lying Down | - | - | + | - |
| Radiographic Changes | - (Normal) | - | +/- (PDL widening) | + (Periapical radiolucency) |
| History of Previous Problems | - | - | +/- | +/- |