Endodontic diagnosis. Mystery or mastery?
Review of 6 clinical distinctions: (1) Symptom: "anything under the sun."


METHODS
pulp exposure. Duplicate: clinical or radiographic pulp exposure evidence.


METHODS
endodontics or pulp cap under strict protocol conditions. (2) Symptom: "cold."


METHODS
hyperemia. Duplicate: ice.


METHODS
pulp protection or endodontics. (3) Symptom: "heat."


METHODS
pulpitis. Duplicate: heat.


METHODS
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."


METHODS
necrosis. Duplicate: Electric Pulp Test and ice are negative.


METHODS
endodontics. (5) Symptom: "I had a toothache awhile back and now it is gone."


METHODS
LEO. Duplicate: Electric Pulp Test, ice, and test cavity are negative.


METHODS
endodontics. (6) Symptom: "It really hurts to touch my tooth."


METHODS
percussion. Duplicate: may or may not have a LEO and may or may not have cellulitis.


METHODS
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."
West
John D
JD
Center for Endodontics, Tacoma, Wash., USA. johnwest@centerforendodontics.com
D003788:Dental Pulp Diseases / Q000175:diagnosis*; D003789:Dental Pulp Exposure / Q000175:diagnosis; D003790:Dental Pulp Necrosis / Q000175:diagnosis; D003791:Dental Pulp Test; D006801:Humans; D006940:Hyperemia / Q000175:diagnosis; D010482:Periapical Abscess / Q000175:diagnosis; D010483:Periapical Diseases / Q000175:diagnosis; D011671:Pulpitis / Q000175:diagnosis