Endodontic diagnosis. Mystery or mastery?
West, J.D.
Dentistry Today 23(5): 80-87
2004
ISSN/ISBN: 8750-2186 PMID: 15164479 Document Number: 580182
Review of 6 clinical distinctions: (1) Symptom: "anything under the sun." pulp exposure. Duplicate: clinical or radiographic pulp exposure evidence. endodontics or pulp cap under strict protocol conditions. (2) Symptom: "cold." hyperemia. Duplicate: ice. pulp protection or endodontics. (3) Symptom: "heat." pulpitis. Duplicate: heat. pulpotomy for multirooted teeth or pulpectomy for single-rooted teeth. Schedule endodontic completion. (4) Symptom: "I recently had a toothache and now it is gone." necrosis. Duplicate: Electric Pulp Test and ice are negative. endodontics. (5) Symptom: "I had a toothache awhile back and now it is gone." LEO. Duplicate: Electric Pulp Test, ice, and test cavity are negative. endodontics. (6) Symptom: "It really hurts to touch my tooth." percussion. Duplicate: may or may not have a LEO and may or may not have cellulitis. reduce occlusion, access cavity, water chew, and schedule to finish endodontics. If these tests are carefully performed, then they are objective and the doctor does not have to be in a subjective situation. A newfound sense of endodontic diagnostic mastery is experienced. Perhaps the best way to summarize the simplicity of this clinical diagnostic scheme is to quote Sherlock Holmes: "Nothing is more deceptive than the obvious."