Diagnosis
Thermal testing: cold (Endo-Ice spray or cold water) and heat tests assess pulp response. Lingering pain to cold indicates irreversible pulpitis.
Electric pulp testing measures pulp vitality by stimulating nerve fibers. Useful for confirming vitality or necrosis.
Periapical radiography to evaluate pulp chamber size, periapical bone, and canal calcification.
Selective anesthesia: anesthetize quadrants systematically to localize the source tooth when patient cannot identify it.
Clinical examination to identify the offending tooth: caries, fracture, deep restorations, and periodontal pockets.