primary function of the dental pulp is to form dentin (by the odontoblasts). Other functions include: Nutritive: the pulp keeps the organic components of the surrounding mineralized tissue supplied with moisture and nutrients; Protective/sensory: extremes in temperature, pressure, or trauma to the dentin or pulp are perceived as pain; Defensive/reparative: the formation of reparative or tertiary dentin (by the odontoblasts); Formative: cells of the pulp produce dentin which surrounds and protects the pulpal tissue. Pulp testing The health of the dental pulp can be established by a variety of diagnostic aids which test either the blood supply to a tooth (Vitality Test) or the sensory response of the nerves within the root canal to specific stimuli (Sensitivity Test). Although less accurate, sensitivity tests, such as Electric Pulp Tests or Thermal Tests, are more routinely used in clinical practice than vitality testing, which requires specialised equipment. A healthy tooth is expected to respond to sensitivity testing with a short, sharp burst of pain which subsides when the stimulus is removed. An exaggerated or prolonged response to sensitivity testing indicates that the tooth has some degree of symptomatic pulpitis. A tooth that does not respond at all to sensitivity testing may have become necrotic. Pulp diagnoses Normal pulp In a healthy tooth, enamel and dentin layers protect the pulp from infection. Reversible pulpitis Reversible pulpitis is a mild to moderate inflammation caused by any momentary irritation or stimulant whereby no pain is felt upon the stimulants' removal. The pulp swells when the protective layers of enamel and dentine are compromised. Unlike irreversible pulpitis, the pulp gives a regular response to sensibility tests and inflammation resolves with management of the cause. No significant radiographic changes are present in the periapical region. Further examination is required to ensure that the dental pulp has returned to its normal state. Common causes Bacterial infection from caries Thermal shock Trauma Excessive dehydration of a cavity during restoration Irritation of exposed dentine Repetitive trauma caused by bruxism or jaw misalignment Fractured tooth exposing pulp Symptoms Temporary post-restoration sensitivity Non-spontaneous and milder pain compared to irreversible pulpitis Short sharp pain caused by a stimulant Differential diagnosis X-rays to determine extent of decay and inflammation Sensitivity tests to see if pain/discomfort is experienced when tooth is in contact with hot, cold or sweet stimuli Tooth tap test (lightweight, blunt instrument gently tapped onto affected tooth to determine extent of inflammation)