If a patient has 0.5 mm pulp exposure and reports hot and cold sensitivity, what is the recommended treatment?

• A. GI liner and fill
• B. Calcium hydroxide, GI liner, and fill
• C. Temporary restoration
• D. Root canal treatment (RCT)

Answer: (D)

In cases where a patient presents with a pulp exposure, such as 0.5 mm in this scenario, and reports symptoms like hot and cold sensitivity, root canal treatment (RCT) is often the most appropriate course of action. This is due to the fact that a pulp exposure indicates a breach in the protective enamel and dentin layers, exposing the dental pulp to potential inflammatory or infectious processes.

When pulp tissue is exposed, the likelihood of irreversible pulpitis increases, especially if the patient is experiencing sensitivity to thermal stimuli. This sensitivity suggests that inflammation is present, signaling the need for more definitive treatment to remove the inflamed pulp tissue and prevent further complications.

While other options like using a glass ionomer (GI) liner or calcium hydroxide could provide temporary relief in managing the symptoms, they do not address the underlying issue of pulp exposure. These treatments may serve to protect the tooth temporarily or manage mild cases of reversible pulpitis, but they are not adequate for a significant pulp exposure, where the risk of infection and pain is high. Therefore, root canal treatment is recommended as a definitive solution that allows for both the removal of necrotic or inflamed tissue and the sealing of the tooth to prevent further irritation or infection.