Pulp Vitality

___________ is a test to determine whether the nerves in the pulp are healthy.

Pulp vitality testing

True or False: Scope of practice for pulp vitality testing varies from state to state.

True

Through what ways does bacteria cause a tooth to lose vitality?

Caries and perio

What mechanical or thermal injuries might cause a tooth to lose vitality?

Traumatic fractures, trauma from dental procedures, traumatic blows, and ortho or orthognathic surgery

What are signs and symptoms of a tooth that has lost vitality?

Sharp, severe intermittent pain

Dull ache, lingers

Soft tissue redness or swelling

Fistula

Facial asymmetry

Discolored tooth

How does a tooth that has lost vitality appear radiographically?

Radiolucent

Calcified pulp canals

Widened PDL

Fractured root

Carious lesion

Large restoration

or not at all

________ is inflammation of the pulp.

Pulpitis

What are signs and symptoms of pulpitis?

Sharp ache/pain

Dull ache

Worsens when reclining

Which condition is described from the following:

-Caused by short-acting stimuli

-Attrition, operative procedures, incipient caries

-Cervical erosion, enamel fractures

-Usually mild pain, short-lasting

-Apply heat, pain worsens over a few minutes

-Change in inter-pulpal pressure

Acute reversible pulpitis or Hyperemia

True or False: With hyperemia, if the cold hurts, the condition is probably reversible.

True

Which condition is described from the following:

-Long duration- radiating pain

-Pain is spontaneous/severe, varying in intensity

-Hyperactive reading on testing

-Heat causes immediate response- cold relieves it

Irreversible pulpitis

Which condition is described from the following:

-Asymptomatic

-No changes elicited in pulpal pressure

Necrosis

During the conversation with the patient, what should the clinician find out about the pain history in order to make a clinical diagnosis?

Location

Type and intensity

Duration

Stimulus

Relief

When making an objective examination, what should the clinician observe in the hard and soft tissues to declare the extent of the disease process?

Decay

Pulp exposure

Abscess and/or cellulitis

Periodontal condition

Restoration present

What supplemental clinical diagnostic tests should a clinician perform to determine pulp vitality?

Percussion

Mobility

Occlusal analysis

Transillumination

Pulp sensitivity tests (hot and cold)

EPT

Radiograph

Selective anesthesia

What is described from the following:

-High frequency current that is used to indicate nerve tissue vitality

-Does not indicate different stages of degeneration

-Can provide false-positives or false-negatives

Electronic pulp test

What factors may influence the reliability of a pulp test?

-Extensive restorations

-Multiple canals (one might be vital and another isn’t)

-As disease progresses, the pulp might produce various responses

-Control tooth might not respond as indicated

-Operator technique/ oral conditions

-Equipment reliability

-Anxiety and pain response

What equipment is needed for an electrical pulp vitality test?

2×2 gauze

Saliva ejector

Cotton rolls

Toothpaste or fluoride

Vitalometer

What is the procedure for pulp testing?

1. Review health history

2. Assemble equipment

3. Patient communication

4. Dry teeth to be tested

5. Prepare vitalometer (toothpaste)

6. Watch for patient indications

What is used for thermal testing for pulp vitality?

Ice, endo ice, gutta-percha or compound material

What is the instrument used for testing percussion of a tooth?

Tooth slooth (idk what this is either)