Significance of a Cold Test

[Brause]

The internet's echo chamber (mainly through dental websites) claims that irreversible pulpitis exists when a cold test causes a lingering sensation for more than XX seconds.

I read in some scientific articles that a cold test can only differentiate between vital and necrotic pulp, but not reliably indicate the state of pulpal inflammation.

What is right?

It is getting interesting, when, in a multirooted tooth, you have a combination of necrotic and vital pulp.

 

[Painful teeth]

I fully agree. When I had my root canals, 2 out of 3 teeth tested normal with cold test. No lingering pain from cold test. Teeth seemed vital.

Upon RC One had 1 canal necrotic the other vital (partial necrosis) RC two the other one was fully necrotic upon opening.

Could be necrobiosis..could be inconclusive testing, could be a tiny remainder of active, non inflamed nerve..

Never had any chewing pain or cold sentivity

I walked around 6 months with this pain because the first endo's did not want to treat. I still have remaining pain though. Could have been a combination of pulpal necrosis and neuropathy. Who knows.

 

[Brause]

Once neuropathy can be ruled out, I will have that tooth 36 pulled. No way getting useless endodontic treatment...and even if it works initially, it i a time bomb. Tooth 36 is one of the chewing workhorses