Endodontics
Course Review
Enoch Ng, DDS 2014
Endo Diagnosis
-
Endodontic objective – absence of apical periodontitis (clinically, radiographically, histologically)
o
Prevention and treatment
-
Endodontic disease – from microorganisms from trauma, caries, and periodontal disease
o
Progression – pulpitis, periodontitis, abscess
-
Endodontic triad – debridement, sterilization, obturation
-
Diagnosis – art of distinguishing one disease from another
SOAP – subjective findings, objective findings, assessment (diagnosis), plan
-
Medical history
o
Bisphosphonates
o
Allergies – latex, medications
o
Uncontrolled diabetes
o
Infectious diseases
o
Infective endocarditis prophylaxis
o
Medications – immunosuppressives, corticosteroids, anticoagulants
-
Dental history
-
Chief complaint
o
Pain, swelling, loose tooth, broken tooth, discolored tooth
o
“Quotation marks” very useful in the record
-
History of present illness
o
Inception – when did problem/discomfort begin? Have you ever noticed it before?
o
Frequency and course – how often does this discomfort occur? Are the episodes more or less frequent
or about the same as when they first started?
o
Intensity – is the discomfort mild, moderate, severe? Patient’s verbal rating of pain from 0-10?
o
Quality – sharp, bright, dull, throbbing?
o
Location
McCarthy’s conclusions – patients experiencing periradicular pain (89%) can localize
painful tooth significantly more often than patients with pulpal pain w/o periradicular
symptoms (30%). Posteriors harder to localize than anteriors.
Can you point to the tooth that hurts/area you feel is swollen?
Were you ever able to tell which tooth was hurting?
Can you tell if discomfort is upper/lower or right/left side?
Does the discomfort start in one place and spread to another?
o
Provoking factors – do heat/cold, biting or chewing cause discomfort?
o
Duration – does discomfort linger when caused?
o
Spontaneity – does the discomfort ever occur all by itself?
o
Attenuating factors – does anything make the discomfort better/worse?
Hot/cold liquids
Sitting up/laying down, bending over
Analgesics
