skip to main content

Irreversible Pulpitis — ORE Part 1 MCQ

Instant feedback + full explanation. One question, done properly.

EasyEndodonticsIrreversible PulpitisORE Part 1

A patient presents with a deep carious lesion in a lower first molar. The tooth has intermittent spontaneous throbbing pain that wakes the patient at night, and pain persists after cold stimulation. What is the most likely pulpal diagnosis?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Symptomatic irreversible pulpitis

**A. Symptomatic irreversible pulpitis** is correct. Deep caries provides the likely pulpal insult, while spontaneous throbbing pain, night waking and pain that persists after cold stimulation indicate severe pulpal inflammation that is unlikely to resolve after removal of the stimulus. SDCEP describes irreversible pulpitis as pain that can occur spontaneously, be dull or throbbing, and typically keep the patient awake at night. Reversible pulpitis is less likely because its symptoms are usually stimulus-related and settle promptly once the stimulus is removed; spontaneous night pain is not expected. Pulp necrosis is less likely because the stem describes a painful response to cold, implying a sensibility response rather than a non-responsive necrotic pulp. Normal pulp is incompatible with the symptoms. Asymptomatic irreversible pulpitis is excluded because the patient has clear spontaneous symptoms.

Reference: Scottish Dental Clinical Effectiveness Programme (SDCEP), Management of Acute Dental Problems, “Pulpitis” section, accessed July 2026: https://www.acutedentalproblems.sdcep.org.uk/guidance/management-of-oral-conditions/common-oral-conditions/pulpitis/