Is pulpitis painful?

Aim To determine whether inflamed dental pulps progress to necrosis without pain. Methodology Records of 2202 maxillary anterior teeth endodontically treated at the University of Michigan were collected. Records of teeth presenting with periapical radiolucencies but no response to vitality tests were examined further to determine, from the history, whether the patient had experienced pain or no pain from the involved tooth. Results Approximately 40% of the teeth included gave no history of spontaneous or prolonged pain to a thermal stimulus. No statistically significant differences in the incidence of 'painless pulpitis' were related to either gender or tooth type. Patients aged >53 years experienced 'painless pulpitis' more often than patients <33 years. Conclusions Many teeth appear to progress to pulpal necrosis without the patient experiencing pain attributable to the pulp.