Pathology · patient case question
How will this patient's pulpal response to cold testing be affected?
Patient case: Patient scheduled for head and neck chemotherapy
Patient: Adult with a head and neck malignancy
Chief complaint: Referred for dental assessment before oncological treatment.
Background: Due to commence chemotherapy for a head and neck tumour.
Current findings: Baseline pulp testing performed as part of the pre-treatment assessment.
Show answer and explanation
Correct answer: D. Reduced response
- A. An exaggerated response suggests irreversible pulpitis, not the effect of oncological treatment.
- B. A complete absence of response would indicate necrosis, which is not the expected general effect.
- C. The response is not unchanged — pulpal sensitivity is measurably altered.
- D. Treatment directed at the head and neck reduces pulpal blood flow and damages the neurovascular supply, producing a BLUNTED but not absent response to thermal testing. This matters diagnostically: a reduced response in these patients must not be misread as necrosis.