Endodontic diagnosis. Mystery or mastery?

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."