A normal tooth will be symptom free and respond normally to pulp vitality test ( a test where the dentist applies small amount of electric current and you will feel a sharp pain if your tooth is alive)
In case where your dentist diagnosed that you have reversible pulpitis in that particular tooth, you might not feel any symptoms at all, but mild, transient pain felt for 10-15seconds when your dentist perform tests such as application of hot, cold stimulus or even blowing air on it . You will have immediate relief after removal of stimulus. We might get delayed response when hot stimulus is applied ( when the dentist heats something that looks like a stick which we called as gutta percha stick on the tooth surface) and immediate response for cold test ( application of dry ice or etc on tooth surface). Normally for reversible pulpitis, dentist will remove the irritants and places a temporar y restoration and keep it under observation for 4-6 weeks time. If you have persistent symptoms after that, irreversible pulpitis and pulp necrosis might had occur and root canal treatment is indicated.
Sequelae to reversible pulpitis is irreversible pulpitis. In acute irreversible pulpitis, you might feel sharp pain and may progress to dull pain when it becomes chronic irreversible pulpitis. The pain might last for few hours and can be felt somewhere on the face.The dentist will get immediate response from the patient when he applies hot and electrical test and the patient will get sense of relief when cold test is performed. The pain might be so severe that it affects the patient’s sleep. For acute irreversible pulpitis, we can either perform root canal treatment or extraction. For chronic irreversible pulpitis, it might be caused by a very huge restoration on your tooth, and you might felt dull pain for a very long time. It might give a poor response to cold/electrical stimulus and root canal treatment is needed to save the tooth.
For a necrotic pulp, you might not feel any pain or have spontaneous pain. You will not have any respond to cold and electrical testing but application of heat might cause pain because there is thermal expansion of gases in the canals. Discoloration might occur in a necrotic pulp and indicates a root canal treatment is required and a crown can be given to mask the discoloration.
When acute apical abscess present, you will feel extremely painful and it feels like the tooth is extruding from the socket, and you feel severe pain when you try to occlude. Swelling of lymph nodes, fever, bad taste might also present with acute apical abscess. Root canal treatment is needed to drain out the pus and allows the healing of periapical lesion.A relief of pain will occur when pus is drained out. If you face any kind of symptoms that you might need a root canal treatment, consult a dentist as fast as possible to allow better prognosis of the root canal treatment.