Patients & dentists
Endodontic diagnosis & pain
Carefully working out whether tooth pain is coming from the pulp, surrounding tissues, or another source, using history, clinical tests, and focused imaging.
An endodontic diagnosis brings together what you describe, a focused examination, sensibility and bite tests, and well-chosen imaging. The aim is to understand the cause before any treatment is started.
Most appointments begin by listening: how the pain started, what makes it better or worse, whether it wakes you at night, and whether earlier treatment helped or did not. Tests and images then check that the picture fits.
What happens
- Symptom history and review of any previous treatment notes.
- Sensibility, percussion, palpation, and bite testing of the tooth and neighbours.
- Focused periapical radiographs; CBCT only when it will change the plan.
- Discussion of likely cause, options, prognosis range, and what is uncertain.
When to consider
- Severe or lingering pain after hot, cold, or biting.
- Pain that wakes you at night or is hard to localise.
- A tooth that has been treated before and is uncomfortable again.
- Swelling, a sinus tract, or unexplained darkening of a tooth.
Diagnosis is the most important step in endodontics. I avoid starting treatment on a tooth until the picture is clear and the tooth is restorable.
The information here is general dental education, not a personal clinical diagnosis. Individual outcomes vary and depend on factors specific to your tooth and your overall health.
Common questions
Questions about this treatment
How is tooth pain diagnosed?
Diagnosis involves a careful history, clinical tests (cold, percussion, palpation), and targeted X-rays. Sometimes cone-beam CT is needed. We work through these systematically before recommending any treatment.
Why is it hard to locate where tooth pain is coming from?
Referred pain is common in the mouth. The nerve pathways overlap, and the brain often cannot localise pain precisely. A thorough examination — not just X-rays — is what finds the source.