Endo Testing

Question 1

Endo Screening Exam

4 signs (symptoms/findings)

Answer 1

Thermal sensitivity (hot/cold)
Pain to biting / chewing
Teeth that hurt spontaneously
Vague orofacial (relating to the mouth or face) pain

Question 2

EPT

Answer 2

Electronic Pulp Tester

toothpaste to act as conductor for EPT

Sterilized tip

Question 3

EPT: what to use for cold test

Answer 3

cotton swabs
endo ice

Question 4

EPT: what to use for heat test:

Answer 4

Gutta percha stick
lighter to warm gutta percha
Vaseline to keep gutta percha from sticking to teeth

Question 5

Types of pulpal tests:

Answer 5

Cold stimulus
Heat stimulus
Electric Pulp test

Question 6

Periapical Test

Answer 6

Biting
Percussion
Palpation
Probing

Question 7

Cold: steps

Answer 7

1.)Spray Endo Ice on cotton swab. NEVER SPRAY TOWARDS PATIENTS FACE
2.)Watch for ice crystals to form.
3.) apply to middle third of buccal surface of tooth
4.)Sick pulp is more sensitive to cold, if pulp is dead (necrotic), you will not feel the cold.

Question 8

Normal / Abnormal responses to cold test:

Answer 8

Normal: feels cold, no pain

Abnormal: cold feels painful, pain stops when stimulus removed - Pain lingers after stimulus removed. Not feeling cold

Question 9

Heat test: steps:

Answer 9

Place thin layer vaseline on buccal surface so hot gutta percha does not stick on teeth
Warm gutta percha holding it above flame until end swells.
Do not hold flame too close to avoid lighting gutta percha on fire
NEVER BURN ABOVE OR IN FRONT OF PATIENTS FACE
Place warm gutta percha on buccal surface of tooth: avoid gingiva and soft tissues.

Question 10

Normal / Abnormal responses to heat test:

Answer 10

normal: slight sense of heat, no sensation.

Abnormal: very painful, lingering pain.

Question 11

Important facts about EPT:

skip

Answer 11

Rate of increase adjusted on numbered wheel
Too high setting can cause pain to paitient
EPT has no on / off switch. turns on automattically
teeth must be isolated / dry
Place small amount of toothpaste on tray cover, dip EPT tip on toothpaste.

Question 12

EPT Procedure

Answer 12

have patient hold end of wand, this completes electrical circuit.
patient lets go of wand when feeling tingling sensation
place end of tip against facial surface of tooth
GREEN light will go on when circuit completed.

EPT TESTS ONLY DONE ON VITAL TEETH (LIVING)

Question 13

What happens if light doesnt turn on during EPT procedure

Answer 13

patient not holding wand
inadequate amount of toothpaste on end of tip
flat end of tip is not against tooth

Question 14

False positives of EPT:

Answer 14

saliva present, patient feels sensation from gingiva of adjacent tooth
Too much toothpaste on EPT tip

Question 15

Periapical tests:

Answer 15

Biting: Patient complains of pain when biting
Percussion: patient has sensitivity or pain when they tap on their tooth / push with their tongue.
Palpation: Pressing gently on tissues with the fingers.

Question 16

Percussion test:

Answer 16

Tooth in question pressed gently with finger

If tooth has pain, other teeth will be tested same way.
If tooth has no pain, mouth mirror handle will tap vertically on occlusal / incisal surface.

Question 17

Normal / Abnormal percussion/palpation results:

Answer 17

normal: no pain

abnormal: sick inflamed periapical tissue (bone) does not like to get pushed on or hit
Periapical infection can be very painful with biting / percussion

Question 18

Biting test:

Answer 18

Patient bites on cotton role

If cracked tooth is suspected, a tooth slooth will be used.

Question 19

Diagnosis of Pulp

Answer 19

Normal Pulp
Reversible Pulpitis (pulp may recover)
Irreversible Pulpitis (pulp will not recover)
Necrotic (dead)

Question 20

to ADD form of Endo SCREEN assessment form:

Answer 20

To add form:
1.) Forms Tab in Tx history
2.) Click on the add record icon + select new classic form
3.)Click on the drop-down menu
4.) Select endodontic Screen Assessment form, click OK
5.) Fill out form according to findings.