Why is there no pain in chronic pulpitis?

[teethexpert]

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Hey everyone I am a dental student and this is a question that I am curious about.

In acute pulpitis the patient feels severe pain so what is the reasoning that in chronic pulpitis the pain disappears even though the pulp is still inflamed?

 

[teethexpert]

In chronic pulpitis, inflammation of the pulp is reversible due to the pulp’s ability to repair inflammatory damage—while this tooth might show hypersensitivity to cold stimuli (i.e., responsive to EPT and cold test), there is no significant degree of lingering pain as seen in acute pulpitis.

In acute pulpitis the pulp is also reversibly inflamed as well right, so why is there lingering pain in acute but not in chronic pulpitis?

 

[yappy]

Where are you hearing the terms "chronic pulpitis" and "acute pulpitis"? Is it being used in your text? Those terms are not dx of the dental pulp.

 

[FutureDent020]

Chronic pulpitis is not an official diagnostic term. Pulpal diagnostic terms are normal pulp, reversible pulpitis, symptomatic irreversible pulpitis, asymptomatic irreversible pulpitis, or necrotic. So don’t concern yourself with “chronic pulpitis”.

 

[BasicG]

Chronic pulpitis is not an official diagnostic term. Pulpal diagnostic terms are normal pulp, reversible pulpitis, symptomatic irreversible pulpitis, asymptomatic irreversible pulpitis, or necrotic. So don’t concern yourself with “chronic pulpitis”.

What's the difference between asymptomatic irreversible pulpitis and necrotic pulp

 

[FutureDent020]

What's the difference between asymptomatic irreversible pulpitis and necrotic pulp

AIP is vital and can only be assumed. You would have to have histology (or I guess pathology) to prove it. Necrosis is proven through sensibility testing. Or can be seen during treatment.

 

[TXftw]

You're mixing up a term for pulpal diagnosis with a term for periodontal diagnosis lol

 

[Firik]

Pretty surprised by the responses.
It's not a pulpal diagnosis, but rather an apical diagnosis with the following findings. Doesn't answer OP's question though.

 

[princeafrica]

Pretty surprised by the responses.
It's not a pulpal diagnosis, but rather an apical diagnosis with the following findings. Doesn't answer OP's question though.

View attachment 358568

“Chronic pulpitis” is not an apical diagnosis either

 

[Firik]

I understand that. By showing the table, I was hoping to show it's not pulpal, but rather apical diagnosis that is acute/chronic. So, OP likely mixed up the terms pulp with apical with the following question in mind:

In acute apical abscess the patient feels severe pain so what is the reasoning that in chronic apical abscess the pain disappears even though the pulp is still inflamed?

Just trying to help out clarifying.

 

[FutureDent020]

I understand that. By showing the table, I was hoping to show it's not pulpal, but rather apical diagnosis that is acute/chronic. So, OP likely mixed up the terms pulp with apical with the following question in mind:

In acute apical abscess the patient feels severe pain so what is the reasoning that in chronic apical abscess the pain disappears even though the pulp is still inflamed?

Just trying to help out clarifying.

The pulp is not inflamed in AAA or CAA. The pulp is necrotic. The pain in AAA is from severe inflammation and swelling in the periapical tissues, not the the pulp. Pain disappears in CAA because there is a sinus tract.