DX

Question 1

Data used to arrive at a DX

Answer 1

pt hx
dental hx
clinical exam
radiograph

Question 2

Test used as part dx clinical exam

Answer 2

Percussion
Palpation
Ice and EPT
Clinical 
Probing
Tooth sluth
Transilluminate
Test cavity

Question 3

what questions to ask for dental hx (emergency exam)

Answer 3

Duration of symptoms
Nature of the pain- changes in pain over time, pain scale
Ever had this kind of pain before
What makes it better and what makes it worse
Have you taken any medication
Any recent dental work

Question 4

Clinical Exam- (6)

Answer 4

Swelling/sinus tracts
Caries, poor resto, fractures, exposed GP
Occlusion
Perio- mobility, local vs gen
Thermal test
Percussion and palpation

Question 5

Vert Root fracture

Answer 5

Localized deep probing depth

F/L

Question 6

A delts fibers

Answer 6

Sharp pain

Question 7

What does a PARL represent

Answer 7

Immune response

Question 8

Pulpal Pain

Answer 8

Very sharp
Temp
Not very well localized

Question 9

Bone Pain

Answer 9

Deep ache or throb
No temp
Palpation and percussion tender
Well localized

Question 10

Bone pain test

Answer 10

Palpation
Percussion
Bitting
Radio

Question 11

Pulpal testing

Answer 11

Thermal test
EPT
Test cavity
Selective anes- max vs man

Question 12

When testing where should you begin

Answer 12

Not at the area of the CC

What pt to know what normal is

Question 13

What are bone pain test looking for

Answer 13

Periradicular inflammation

Incomplete crn fracture

Question 14

Percussion test

Answer 14

Good to find a tooth that is acutley painful with periradicular inflammation

Question 15

Palpation test

Answer 15

Good if the inflammation has penertrated the alveolar bone

Question 16

Test when a pt CC is bitting pain

Answer 16

A bite test

Look for signs of fracture

Question 17

Goal of pulp testing

Answer 17

To reproduce pt CC or change the nature of their pain

• Reproduce pain
• Eliminate pain
• Chnage the severity of pain

Question 18

Normal for pulp testing

Answer 18

Need to test adjacent teeth to determine normal to then be able to decide what is abnormal

Question 19

Ice water immersion

Answer 19

Good for ppl whos CC is cold water and cant replicate with endo ice

• place RD and then put cold water on
• Also can use a piece of ice
• Good for cracks, open margins

Question 20

Heat test

Answer 20

Good when heat is CC and cant chnage symptoms with cold
- RD and hot water
or CP and hot water

Question 21

Casue of false positive with pulp test

Answer 21

Gingiva response
Anxiety
Adjacent teeth
Percussion vs temp sensation

Question 22

Causes of false negatives

Answer 22

Calcified canals
Restorations
Trauma
Poorly done test- not cold enough etc

Question 23

EPT

Answer 23

All or none vital or not

Tooth must be dry

Question 24

Test Cavity

Answer 24

Last resort- Get past DEJ and no sensation–> Necrotic

Question 25

Selective Anes

Answer 25

Good to defferenciate max from man

Question 26

Radiographic exam

Answer 26

``` Caries Deep resto Previous RCT Pulp chamber and canals PDL and root surface Surrounding perio/bone ```

Question 27

Radio exam limitations

Answer 27

Onlt 2-D

Question 28

Misleading factors in DX

Answer 28

``` Imprecise endo testing- poor pt communication Lack of pulpal perception Referred pain Distracted but other "obvious" findings Mislead by another dx ```

Question 29

How to avoid errors in dx

Answer 29

``` Listen to pt ask why Dont jump to radio conslusions Clinical matches radio Test are well done and thorough ```

Question 30

Cracked tooth

Answer 30

``` Tooth sluth Trans illuminate Bite test 80% get better with cuspal coverage 20% will need RCT ```