When a tooth is causing pain, it may feel like the whole side of the mouth hurts. How does a dentist isolate the pain to determine if it needs root canal? There are several techniques.
Tap, tap. First the dentist will apply percussion. Endodontically involved teeth, those whose nerves are diseased or damaged, almost always feel differently to percussion than teeth with normal pulps. If more than one tooth reacts to percussion, the tooth that is most reactive is the one to treat. It is possible that multiple teeth need endodontic treatment. Its important to note that reaction to percussion on the top jaw may be an indication of sinusitis – pain not coming from a tooth.
Thermal sensitivity is another sign – hot and cold. This symptom may include repeated visits to the dentist to address the issue but it remains unresolved. Often the patient will take something for pain like aspirin or Tylenol and diagnosis becomes compromised as a result. The dentist should have the patient return the next day, this time without taking any medication for six hours before the visit. If the pain is specifically to cold, duplicate this symptom. The dentist may apply EndoIce (Endoco) to simulate the stimulant. If the pain is caused by heat, the dentist could isolate each tooth with a rubber dam and bathe them in hot liquid.
Finally, a cracked tooth may cause pain each time you bite which can cause the crack to open a bit each time. A tool called a Tooth-Slooth (available from EndoSolutions) allows the patient to bite on one cusp at a time to narrow down where the crack may be.