Poorly Localised Pulpal Pain — NDEB AFK MCQ

Correct answer: D — Pulpal pain from irreversible pulpitis (deep visceral-type pain mediated by C-fibres)

Pulpal pain, especially from irreversible pulpitis, is characteristically poorly localised because the dental pulp lacks proprioceptive fibres — pain signals from the C-fibres (slow, dull, aching, throbbing pain) converge in the trigeminal nucleus with inputs from other teeth and structures, causing referred pain. Patients may be unable to identify which tooth is causing the pain, and pain may be referred to other teeth, the ear, temple, or opposing arch. Once the infection extends beyond the apex into the PDL (where proprioceptive fibres exist), the pain becomes well-localised.

Reference: Torabinejad – Endodontics: Principles and Practice, 6th ed., 2021