Summary of "Reversible Pulpitis Vs Irreversible Pulpitis: Symptoms, Diagnosis, Testing, and Management"

Main Ideas and Concepts:

Definition of Pulpitis: Pulpitis is inflammation of the dental pulp, the innermost part of the tooth containing nerves and blood vessels. The inflammation is usually caused by bacterial infiltration through carious lesions or fractures.
Pathophysiology: Bacteria such as Streptococcus mutans, Lactobacillus, and anaerobic species invade the pulp, triggering an inflammatory response. This leads to increased pressure inside the pulp chamber, pain, and tissue damage. If untreated, pulpitis can progress to necrosis, where the pulp tissue dies irreversibly.
Causes of Pulpitis:
- Untreated dental caries
- Recurrent caries under restorations
- Deep restorations
- Trauma or fractures exposing the pulp
Types of Pulpitis:
1. Reversible Pulpitis:
  - Inflammation is temporary and the pulp is not irreversibly damaged.
  - Usually caused by irritation from bacterial toxins without direct infection of the pulp.
  - Symptoms include short-lived sensitivity, often triggered by cold (sometimes heat).
  - Sensitivity subsides quickly once stimulus is removed.
2. Irreversible Pulpitis:
  - Infection extends into the pulp causing irreversible damage.
  - Symptoms include severe, spontaneous pain that may worsen at night or when lying down.
  - Pain may linger after removal of stimulus and can be sensitive to pressure.
  - Sometimes asymptomatic if progressed to necrosis (dead pulp).
Risk Factors:
- Poor oral hygiene
- Infrequent dental check-ups
- High sugar intake
- Compromised immune system
Diagnosis:
- Comprehensive dental examination and patient history focusing on pain characteristics.
- Clinical assessment of decay and other contributing factors.
- Pulp Testing:
  - Pulp Sensibility Tests (e.g., CO2 test, Electronic Pulp Test [EPT]) to check pulp vitality. A response indicates a vital pulp; no response suggests necrosis.
  - Pulp Sensitivity Tests (thermal tests):
    - Cold test using refrigerant spray or cold stick.
    - Heat test using warm gutta-percha or heated instrument.
  - Lingering pain to heat or cold generally indicates Irreversible Pulpitis.
  - No response to thermal stimuli may indicate necrotic pulp.
- Imaging:
  - Periapical radiographs to detect apical radiolucencies and assess extent of decay/inflammation.
Management:
- Reversible Pulpitis:
  - Focus on treating the cause of irritation, primarily through restorative dental treatments (e.g., filling cavities).
- Irreversible Pulpitis:
  - Requires more invasive treatment such as Root canal therapy to remove infected pulp and preserve the tooth.
  - In advanced or severe cases, extraction may be necessary if preservation is not feasible.

Methodology / Diagnostic and Treatment Approach:

Step 1: Clinical Evaluation
- Obtain detailed patient history (pain characteristics, triggers, duration).
- Examine tooth for caries, fractures, restorations.
Step 2: Pulp Testing
- Perform pulp sensibility tests (CO2, EPT) to assess pulp vitality.
- Conduct thermal sensitivity tests (cold and heat) to differentiate reversible vs Irreversible Pulpitis.
Step 3: Imaging
- Take Periapical radiographs to evaluate the periapical status and extent of decay.
Step 4: Diagnosis
- Use clinical findings and test results to classify pulpitis as reversible or irreversible.
Step 5: Treatment
- For Reversible Pulpitis: Remove irritants and restore tooth structure.
- For Irreversible Pulpitis: Perform Root canal therapy or extraction if necessary.

Speakers/Sources Featured:

The subtitles do not explicitly identify any individual speakers or sources. The content appears to be delivered by a single narrator or presenter, likely a dental professional or educator explaining pulpitis.

End of Summary