The term “clinically normal pulp” is used to classify
a pulp that has no signs or symptoms to suggest that
any form of disease is occurring. The term “clinically”
is used since such a pulp may not be histologically
normal and/or may have some degree of fibrosis
(scarring) as a result of previous injury or stimuli.
A clinically normal pulp is asymptomatic. It
produces a mild and transient response to various
stimuli but the nature and severity of the response may
vary according to the age and state of the tooth. As
long as there has been no calcification of the coronal
pulp space, a clinically normal pulp will react to cold
stimuli with mild pain that lasts for no more than 1–2
seconds after the stimulus is removed. A clinically
normal pulp does not respond to heat stimuli.
Percussion and palpation tests will not elicit any
tenderness. Radiographic examination will demonstrate
normal appearance of the pulp chamber, root canals
and periapical tissues.
Dentine is usually sensitive when exposed to irritants
hence dentine sensitivity should be distinguished from
pulp inflammation.
Dentine sensitivity
When pain occurs with thermal, chemical, tactile, or
osmotic stimuli associated with exposed dentine, the
diagnosis is dentine sensitivity. The pain is consistent
with an exaggerated response of the normal pulpo-dentinal complex,
and it is severe and sharp on
application of the stimulus to the exposed dentine.
Nonetheless, there is no lingering discomfort once the
stimulus is removed.
When there is a specific factor (other than exposed
dentine) causing the sensitivity, such as caries, fractures,
open restoration margins or recent restorative
treatment, teeth may exhibit symptoms that are
identical to dentine sensitivity. When symptoms
develop in these situations, a diagnosis of reversible
pulpitis is appropriate.