Clinical tests: percussion, palpation. periodontal probings, mobility. Rule out Non- odontogenic pain, CO2 thermal tests to rule out adjacent teeth.
Diagnostic tests donot give us a definitive diagnosis. Most tests do not actually access the vitality ( blood circulation) of the pulp and most do not give much in any indication about the presence or severity of inflammation in the pulp. The Main reason for doing pulpal tests are to reproduce symptoms, to localize the symptoms and to access the severity of symptoms.
- There is a poor correlation between clinical symptoms and pulpal histopathology.And likely inaccurate!
- Responses are Subjective and can be under or overstated (Eli, 1993 Dental anxiety: A cause for possible misdiagnosis of tooth vitality)
- Responses are subjective and likely overstated ST
• Seltzer & Bender, 1963 The Dynamics of Pulp Inflammation: Correlations between diagnostic data and actual histologic findings in the pulp.
• Tyldesley & Mumford, 1970 (Dental pain and the histologic condition of the pulp) Classic: Examined 142 teeth with pain. No correlation between histology and clinical symptoms.
• Schindler, Heat test – used on refractory cases to identify missed canals or late stage of an irreversible pulpitis
• Garfunkel, 1973 Dental Pulp pathosis: Clinicopathologic correlations based on 109 cases.
Senia, Cunningham, 1985 The diagnostic dilemma of barodontaliga. Report of two cases. Barodontalgia – sensitivity or pain caused by exposure to a pressure gradient. Fliers & Divers