Pulps age! With age, nerve and blood supply to the
pulp tends to decrease, and the pulp becomes more
fibrous and less cellular.
As a result, the pulp may
become less equipped to mount a defensive reaction to
injuries. However, dentine permeability reduces with
age as a result of a progressive reduction in tubular
diameter and an increase in the formation of peritubular
dentine. This provides a more protective environment
for the pulp.
The dental pulp usually remains walled off by a thin
layer of dentine and predentine until late in the disease
process of external invasive resorption. Secondary
invasion of micro-organisms into the pulp will elicit
pulp inflammation when enough dentine has been
destroyed.
Some systemic diseases have dental anomalies. In
hereditary hypophosphataemia, the size of the pulp
horns tends to increase and dentine is more susceptible
to bacterial ingress. Patients with sickle cell anaemia
tend to have more frequent toothache which may be
due to abnormal blood flow to the pulp.