Dental pulp and its physiological functions.

Dental pulp is the most centered area within the tooth. It is parallel to the long axis of the tooth and it’s an integral part of a second layer called dentine which surrounds the pulp

It is considered a soft tissue because contains blood vessels and nerves. One of the most important functions of DP is providing minerals and organic mater to the tooth feeding it with most important nutritive elements needed in giving rise to other layers like dentine enamel and cementum.

Dental pulp chamber has a major role in the tooth development process by giving rise to ameloblasts. Amaloblasts are the primary cell unit of dentine. Odontoblasts on the other hand interact with epithelium in creating ameloblasts which are the primary cell unit of enamel. Dental pulp is a vital component of the tooth by not only providing it with blood vessels but nerves as well. The function of the pulpal nerves is related to the tooth sensitivity, immune system signalization (protective function), hydration etc.

The injury of the pulp can cause discomfort to the patient. It is very important to maintain a healthy pulp in prosthetic and restorative procedures like bridges and crowns and all restorative procedures (dental fillings). Dental pulps size and shape varies from patient to patient. All the clinicians have to consider the anatomy of the pulp before opening a cavity. That’s why an x-ray is always helpful in determining future treatment.

Pulpal interventions in partially developed teeth are not as practical as teeth that are fully developed. In these cases different procedures are applied.

Determining the best possible treatment plan based on the clinical or radiographic signs in many pulpal diseases are not always possible because the origin of a lesion for example could be related to non dental origin. In this case a well examined dental and medical history and consultation with the the patients physician is necessary   The clinician needs to have considerable knowledge of the pulps biology and has to be experienced in performing pulpal interventions.

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Endodontics is the science that studies periradicular and pulpal diseases. It’s a very important branch of dentistry that focuses its attention in these areas:

Morphology, physiology and  pathology of the human dental pulp and periradicular

tissues.

This discipline deals with different procedures and its divided in many categories. As the technology and the science advances in discovering more materials that will facilitate endodontic procedures, the basis of root canal therapy remain the same. Including  here root canal irritants, obturation of the canals system etc. Clinical treatment of endodontics remains integrated closely to other dental disciplines. A dental student should have basic background in oral anatomy, infection healing and repair, systemic disease, pharmacology, medical emergencies in a dental office, pain control through pharmaceutical drugs and anesthesia etc. So in order for someone to be in able to comprehend endodontics, one should be knowledgeable in basic dentistry. Endodontic procedures include uncomplicated and complicated cases. These are two procedures that can be completed by either a general dental practitioner (GP) or an endodontist specialist.

What is the difference between a GP and an endodontist ?

Every dentist, General practitioner dentist included should be in able to perform an easy root canal procedure

(i.e root canal on anterior teeth  this is considered an uncomplicated root canal). But as I mentioned earlier there are many different types of complicated root canal procedures (i.e  Root canal on posterior teeth, especially first and second molars). These types of complicated procedures as well as other challenging diagnoses are always preferred to be done by the endodontist specialist. A general practitioner (GP) has to accurately diagnose the pulpal situation of the clients tooth and evaluate his level of competency in performing complicated endo procedures. If the (GP) possesses less competency level of skill then he MUST refer the client to the endodontist specialist for further investigation towards a successful treatment.

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