Endodontic diagnosis. Mystery or mastery?

ABSTRACT

UNLABELLED Review of 6 clinical distinctions (1) Symptom "anything under the sun." DIAGNOSIS pulp exposure. Duplicate clinical or radiographic pulp exposure evidence. TREATMENT endodontics or pulp cap under strict protocol conditions. (2) Symptom "cold." DIAGNOSIS hyperemia. Duplicate ice. TREATMENT pulp protection or endodontics. (3) Symptom "heat." DIAGNOSIS pulpitis. Duplicate heat. TREATMENT 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." DIAGNOSIS necrosis. Duplicate Electric Pulp Test and ice are negative. TREATMENT endodontics. (5) Symptom "I had a toothache awhile back and now it is gone." DIAGNOSIS LEO. Duplicate Electric Pulp Test, ice, and test cavity are negative. TREATMENT endodontics. (6) Symptom "It really hurts to touch my tooth." DIAGNOSIS percussion. Duplicate may or may not have a LEO and may or may not have cellulitis. TREATMENT 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."