A new look at the diagnosis of pulpitis

The diagnosis of pulpitis has remained static for what seems like centuries, namely, that a diagnosis of irreversible pulpitis leads to treatment by extraction or by root canal filling, with the latter allowing the tooth to be retained, but with the requirement of a (potentially expensive) cusp coverage restoration. It was fortuitous that my attention was drawn to a recent paper1 shortly after I saw a lower molar tooth which, to all intents and purposes appeared non-vital, but which had one vital root canal. In this paper, a group of pre-eminent endodontists propose a new classification which, somewhat perversely, will reduce the number of root canals that they will need to fill but questioning whether the term ‘irreversible’ should continue to be used. Given that only a small proportion of readers of Dental Update will have access to the journal in which this was published (International Dental Journal), I will precis the findings from the paper for readers.