Please review the instructions carefully and respond to all questions, including the two learning goals, using your own words. Your submission should consist of three to four well-developed paragraphs
Student #1
The pulp in our teeth is what makes them "alive." It's innervated with blood vessels and nerves that enter through the apical foramen of the tooth's root. It assists in initiating tooth development, providing odontoblasts to form dentin, senses temperature and pressure, has white blood cells for inflammatory and immune responses, and forms reparative dentin. Therefore, because of its many roles, it is important to preserve and protect the pulp tissue from infection and trauma.
Even though the pulp is hidden inside the tooth's walls, it does not mean that the pulp portion is safe from complications. One major threat to the dental pulp are decay of the teeth. Once the bacteria reaches the pulp, it infects the pulp and causes it to inflame. The bacteria also has an express ride to the apical foramen of the root, which causes an abscess deep in the maxilla or mandible where the tooth's root rests. This is why cavities are painful and your teeth become even more sensitive to temperature and pressure. Another major complication is trauma to the teeth such as a fracture or broken tooth exposing the pulp to external elements. This would especially make the tooth more vulnerable to bacteria. Similarly, tooth grinding and clenching can also wear the tooth down exposing the layers of the teeth and eventually the pulp.
Clinicians also have to be careful to not damage the pulp during procedures. When scaling teeth we should take care to avoid cavities and areas where the teeth are broken. Other procedures such as ultrasonic scaling and polishing can also heat up the tooth and damage the pulp. Even when dentists are performing fillings, they try their best to avoid drilling into the pulp cavity because an interference into the pulp cavity would lead to needing a root canal.
Radiographic assessments are imperative for dental diagnosis and treatment. It allows us to identify and verify problems we would and would not optically see such as cavities, bone loss, impaction, current restorations, and other dental anomalies. Many patients may not want x-rays because of the fear of radiation, however, the radiation levels in digital X-rays are very minimal. We would be getting more radiation in our daily lives from being in the sun and around appliances such as our phones and microwaves.
Student #2
Pulp pathology at face value to the general public can easily come across as a restorative issue more so than a preventative issue – and thus, seem like a dentist and dental assistant’s obstacle over a dental hygienist’s. However, with a wider perspective on the oral cavity and the connection between each structure, we know that isn’t the entire case.
Pulp pathology, if gone unaddressed, has the potential to bleed into the surrounding tissues. This is due to a variety of things such as the pulp being in an enclosed space – making it impossible to heal, or the accessory canals that are direct routes for infection to spread between pulp and periodontal ligaments. Because of how closely dental hygienists work in assessing a patient’s periodontium, they could be getting the first look at diseased tissues that will require further care by a DDS.
Radiographs are a key feature in being able to address these types of issues within the periodontium. Radiographs, while only two-dimensional, offer a part of a patient’s oral picture that perio assessments simply cannot do. Because these abscesses and cysts related to pulp pathology are within the periapical region, radiographs are necessary in order for dental professionals to see beyond the clinical view of the oral cavity.
Although the most common cause of pulpal inflammation is tooth decay, scaling as a mechanical source of injury can also be a cause. As dental hygienists, this is why it’s important to maximize conservation of as much natural tooth structure as possible. Also, being aware of if a patient is struggling with pulpitis – in conjunction with having radiographic images – would allow hygienists to approach the coronal portion of a tooth with more care.
Attached is a DDS’s explanation on pulpitis that helped deepen my understanding on the pathology of a pulp infection.
Student #3
After learning more about dentin and pulp, I realized how important it is for us as future dental professionals to understand what is happening inside the tooth. We usually focus on what we can see during the intraoral exam, but the dentin and pulp play a huge role in how the tooth reacts to many things like decay, trauma, and even normal dental procedures. When dentin is affected, the pulp often reacts, so knowing this helps us connect the dots of why a patient might feel sensitivity or discomfort.
I learned the differences between reversible and irreversible pulpitis, pulp necrosis, and conditions like internal resorption or pulp calcifications. First, reversible pulpitis usually means quick sensitivity that goes away once the stimulus is removed. On the other hand, irreversible pulpitis is more serious and often comes with lingering or spontaneous pain. Next, internal resorption caught my attention because it creates a round radiolucent area inside the root canal that can easily go unnoticed if you are not looking carefully. I also learned that things like pulp stones do not usually cause symptoms, but they are important findings because they can make future dental treatment more complicated.
All of this shows how important radiographs are during patient care. Many pulp problems cannot be seen just by looking in the mouth. Radiographs help us identify early signs of issues such as periapical radiolucencies, widening of the periodontal ligament space, or internal resorption, even when the patient feels fine. As dental hygienists, we will not be diagnosing these conditions, but we are often the first people to notice something unusual. Recognizing these changes, documenting them clearly, and bringing them to the dentist’s and patient’s attention is a big part of keeping our patients healthy. Understanding pulp pathology helps us provide better care and makes us more confident in what we are looking for during treatment.
