Establishing a diagnosis prior to proceeding with endodontic treatment is of paramount importance.

Electric pulp testing (EPT) is useful for single rooted tooth. If a tooth does not respond to an EPT, it is necrotic. EPT is not useful for multi-rooted teeth because a positive response to an EPT only means that some vital pulp tissue is present.

Thermal testing:

The devices you use for thermal testing should have a constant temperature. This means that an ice pencil is superior to an aerosol spray because a cold cotton pellet warms as it is transferred to the patient’s mouth and warms while engaging the tooth.

A sharp, non-lingering sensation to cold typically indicates reversible pulpitis.

A sharp, lingering sensation to cold typically indicates irreversible pulpitis.

An electronic heating system (EHS) can be used to conduct a heat test. Common electronic heating systems are:

• Touch and Heat
• System B
• Elements Obturation Unit

Heat tests are useful when a cold test is inconclusive or where stimulation by cold offers relief.

Always test the suspected tooth last.