Based on the clinical presentation (lingering cold pain >30 seconds after stimulus removal), what is the PULP diagnosis for tooth #19 in this pregnant patient?

Correct answer: C. Symptomatic irreversible pulpitis

• A. Pulp necrosis may present with spontaneous pain initially that subsides as the nerve dies — however, a necrotic pulp would typically NOT respond to cold testing. The cold response (even if exaggerated) indicates some vital pulp tissue is still present.
• B. Reversible pulpitis produces sharp pain that resolves quickly (<5–10 sec) after the stimulus is removed. The pain does not linger. Treatment = remove the cause (deep caries removal, restoration).
• C. CORRECT. Symptomatic irreversible pulpitis is characterized by: spontaneous or elicited pain that LINGERS for more than 10–15 seconds after the stimulus is removed. Lingering pain indicates the pulp is unable to return to its pre-stimulus state, signifying irreversible inflammatory change. Treatment = pulpectomy/RCT.
• D. A normal pulp produces a brief, mild, and transient response to cold that resolves immediately after stimulus removal.