The symptoms of acute suppurative pulpitis include low-grade fever, pain, soreness of the tooth, and facial swelling. Pain is usual induced by hot liquids, a reaction believed to be caused by expansion of gases produced by gas-forming bacteria trapped inside the root canal. Sampling from the root canal for recovery of organisms, before treatment, during treatment and at the end of therapy to ensure eradication of the infection is useful, and can differentiate between infectious and non-infectious pulpitis.

The patient may experience intense pain that may be difficult to localize. It may be referred to the opposite mandible or maxilla or to areas supplied by common branches of the fifth cranial nerve. X-rays, pulp testers, percussion, and palpation are helpful aids in confirming the diagnosis.

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