The sensitivity or responsiveness of a dental pulp is a key indicator to vitality. Over the years people have developed varying methods to test the responsiveness of teeth including cold, heat and electricity. The first thing to think about are the qualities of a pulp responsiveness test.
Using cold, heat or electric pulp testing meet these criteria. The next piece of information is which one produces the most accurate information considering the results will cause us to pick up a handpiece and access the pulp chamber, which is not irreversible. A recent study compared these three methodologies. The cold test was performed using a cotton pellet sprayed with 1,1,1,2-tetrafluoroethane. This material does not convert to a liquid when placed against the tooth, rather it evaporates eliminating the risk of it dripping onto tissue or touching other teeth. For heat, the study used a heated gutta-percha rod. The electric pulp tester was used with a response level of less than 70 being positive. The study showed that the probability of a sensitive reaction representing a vital pulp was 90% with a cold test, 89% with heat and 83% with an electric pulp test. These results would indicate that a cold test was the most accurate in predicting a vital pulp based on responsiveness of the pulp.