Diagnosis

The reaction of pulp tissue in primary teeth to deep caries differs from that seen in the permanent dentition and is characterised by the rapid spread of inflammatory changes throughout the coronal portion of the tooth. These pathological changes become irreversible and, if left untreated, will involve the radicular tissue. There may be few, if any, clinical symptoms in the early stages to indicate the extent of tissue damage. Pain may only occur after involvement of the periradicular tissues in the spread of infection.
Children are often unable to give accurate details of their symptoms, and the responses to clinical tests may be unreliable. Difficulties are frequently experienced in ascertaining the condition of the pulp from clinical findings.

Radiographs, which are essential prior to the commencement of treatment, may give little information of early pathological changes.