larger blood supply. In general, pulp stones do not require treatment. Depending on the stones' size and location, they may interfere with endodontic treatment and should be removed. Complications Pulp acts as a security and alarm system. Slight decay in tooth structure not extending to the dentin may not alarm the pulp, but as the dentin gets exposed, due either to dental caries or trauma, sensitivity starts. The dentinal tubules pass the stimulus to the pulp's odontoblastic layer, triggering the response. This mainly responds to cold. At this stage, simple restoration can be performed. As the decay progresses near the pulp, the response magnifies. Sensation to heat and cold increases. At this stage, indirect pulp capping may be adviseable. At this stage it may be impossible to clinically diagnose the extent of decay. Carious dentin by dental decay progressing to the pulp may get fractured during mastication, traumatizing the pulp, resulting in pulpitis. Pulpitis can be painful and may call for root canal therapy or endodontic therapy. Traumatized pulp starts an inflammatory response. The hard and closed surroundings builds pressure inside the pulp chamber, compressing the nerve fibres and eliciting pain. At this stage, the pulp starts to die, progressing to periapical abscess formation (chronic pulpitis). Pulp horns recede with age. The pulp undergoes a decrease in intercellular substance, water, and cells as it fills with collagen fibers. This decrease in cells is evident in the reduced number of undifferentiated mesenchymal cells. The pulp becomes more fibrotic, reducing the regenerative capacity of the pulp due to the loss of these cells. The overall pulp cavity may become smaller by the addition of secondary or tertiary dentin and cause pulp recession. The lack of sensitivity associated with older teeth is due to receded pulp horns, pulp fibrosis, the addition of dentin, or all these changes. Restorative treatment can be performed without local anaesthesia on older dentitions. See also Dental pulp stem cells Dental pulp test References Further reading Parts of tooth Tissues (biology)