Sensibility

Cold Testing

• Ethyl chloride

  • Spray

  • Applied with cotton wool

  • -5 degrees

• The ethyl chloride is sprayed onto the cotton wool, heald with tweezers, well away from the patient’s face

• Ask them when they feel the cold temperature on their tooth

• Start with a tooth you expect to be healthy to use as a baseline

• Start by gently applying pressure to the enamel of the tooth and repeat on several teeth until reaching the tooth in question

• Pay attention to if it is hyper-responsive, the same or delayed

• Try avoiding touching the dentine, restorations or gingivae

TTP

• To check for mobility, use two hands instrument handles to carefully move the teeth forwards and back

• To check for apical movement, we can very gently tap the tooth to see if the patient feels it is tender to percussion, especially in comparison to a healthy tooth

Electric Pulp Test

Dials or digital displays

• When using an EPT we first place some OptiLube into a dappens dish

• The aim of the EPT is to deliver an electric current to stimulate the closest myelinated A-delta fibres in the tooth

Black box = dial EPT

• Tip is detachable and autoclavable

• The handle is wipeable to use again

Check to ensure the tip is secure once inserted. When the device is turned on, a green light will indicate it has battery life.

• OptiLube is applied to the tip of the EPT and placed on a tooth that you expect is healthy for reference

• Ask your patient to hold the handle of the EPT and this will complete the circuit (otherwise no readings)

• Explain they should feel a sensation through the tooth as you turn the dial and you would like them to tell you when that is

• Use one hand to stabilise the tip of the tooth and the other to slowly turn the dial.

• Once the patient feels the sensation, make a note of this value then move on to compare it to several other teeth and the tooth in question

• The difference between the healthy teeth and the questionable tooth, is important.