The Most Common Endodontic Diagnostic Tests

Before receiving a root canal or other endodontic treatment, your endodontist will need to run a few endodontic diagnostic tests. Here at Ballantyne Endodontics, we’re big believers in the power of diagnosis because it helps us create a customized treatment plan for you and your teeth. Your clinical exam gives us the information we need to offer you the best care possible.

This guide to common endodontic tests isn’t a substitute for individualized care. The exact sequence of tests may vary depending on your chief complaint and your medical history. We hope this article will help you feel better prepared for your diagnostic examination.

These are the most common types of endodontic diagnostic tests you can expect to experience at your visit.

Visual Examination

Your endodontist will conduct a visual exam to look for signs of infection, awkward bite, facial asymmetry, or other symptoms. This isn’t our main source of diagnostic information, but there are some clues a trained eye like ours can quickly recognize.

Your dental team may also talk with you about your symptoms, where and when you experience pain, and other aspects of your overall health and history. By getting to know you, we can better treat you.

Learning About Your Chief Complaint

A skilled and compassionate endodontist treats you as a whole person. We may be dental specialists, but we know you’re a whole person, and what’s going on in your whole body impacts what’s happening in your mouth, and vice versa. 

Our essential diagnostic tools include a mix of objective testing and seeking more subjective information about what you are experiencing.

Your endodontist may talk with you and ask questions. You can prepare by considering the questions we’ve listed below. Just be sure to always give your honest answers in the moment rather than over-rehearsing answers.

Learning About the History of the Chief Complaint

The most important first step in establishing a diagnosis is for your endodontist to gain a thorough understanding of the history of your symptoms. So many things our patients tell us are really important for reaching a diagnosis! This is all extremely crucial context for us. This list of questions was inspired by Dentistry IQ, and you may hear us ask any or all of these:

  • Can you pinpoint the source of the discomfort?
  • Are your teeth sensitive to temperature (like heat or cold)? If not now, what about in the past? Describe this sensitivity.
  • Have you noticed any swelling? Where?
  • Have you ever felt the need to use pain medication because of your tooth? Have you taken any antibiotics?
  • Have you experienced muscle pain in your face, neck, or both?
  • Is the discomfort worse at certain times of day, like at night or in the morning?
  • Have you had sinus problems?
  • Is the pain or discomfort spontaneous?
  • Are you sensitive to pressure, such as biting down or chewing?
  • Does the pain ever wake you at night?
  • Have you had recent dental work?
  • Do you ever clench or grind your teeth?

Your endodontist may ask different questions, and this list is just a prompt to get you thinking about your specific experience. Consider your answers before your appointment, then share this information with them. Your endodontist is like a detective, and your answers are important clues to what your diagnosis really is.


Imaging is essential to any dental practice, especially endodontics. Sophisticated imaging tools allow us to see better what is going on inside your tooth. Since the root canal system is so exquisitely tiny, we rely on imaging to enlarge the area and make it easier for us to see those minuscule details.

At Ballantyne Endodontics, we use these powerful imaging tools:

  1. Digital radiography is an advanced non-film system that produces 90% less radiation than low-dose dental x-rays. It helps us understand what’s going on inside your teeth and mouth, so we can design a treatment plan that can resolve your concerns.
  2. Cone Beam 3D technology is another specialized imaging system that provides three-dimensional images of your teeth, soft tissues, nerve pathways, and bone, all within a single scan. We love it, and it is really a game-changer that helps us help you!

These tools give us a “clear picture” and serve as a map to your best treatment.

Vital Pulp Testing

Most endodontists use a series of tests to evaluate the vitality of a patient’s dental pulp. Tests assess the reaction of the pulp to temperatures (cold or hot), as well as how it responds to an electric test and cavity tests.

Your pulp contains a network of highly sensitive nerves. Your pulp tissue may be normal (healthy), inflamed, or infected. If the pulp is inflamed or infected, you will be experiencing sensitivity and pain. We must assess the severity of the infection before your endodontic treatment.

During a root canal, your endodontist will thoroughly clean and disinfect the pulp within your affected tooth. Understanding its condition makes the procedure more effective and more comfortable for you.

Your endodontist will also conduct thermal tests on the cervical aspect of the tooth. This is the location with the thinnest enamel, so it is closest to the pulp. Your endodontist will be looking for feedback from you on the intensity, duration, and immediacy of the response. Your dentist might ask you to rate the intensity from 0-10. Make sure you answer them candidly.

Periapical Tests

Your endodontist may perform periapical tests to assess your bite. Some tests involve using percussion or palpation. We do this to help locate the offending tooth, and also learn how far the infection has progressed.

Since the pulp itself lacks proprioceptors (which are sensory receptors that receive information about stimuli), many patients have difficulty describing exactly where the pain comes from. But the periodontal ligament does have proprioceptors, so once the issue has spread to the ligament, it is easier to identify the source through percussion and palpation tests.

Your endodontist may perform percussion tests using a gloved finger, a “Tooth Slooth,” or another plastic instrument. The test will be as gentle as possible.

The goal for these and other diagnostic tests is to provide excellent care and the right treatment for your concern. Information is power, especially when it comes to diagnosis!

There are other endodontic diagnostic tests your endodontist may use, especially if there are signs of fracture or other tooth trauma. Ask your endodontist about which specific tests you may need and what you can expect.

Next Steps: Schedule a Consultation

If you learn you need a root canal, consider seeking care from a specialist. An endodontist performs root canals daily, while a general dentist may just perform one or two a week when it comes to your tooth’s complex root canal system; experience matters!

Look for an endodontics practice that uses state-of-the-art imaging and diagnostic tools. Also, look for compassionate care providers who prioritize minimally invasive techniques whenever possible. And remember that, when your provider recommends endodontic diagnostic tests, this is to help them understand exactly what is going on with your tooth. From there, they’ll be able to create an accurate treatment plan to get you back to health.

The team at Ballantyne Endodontics has worked hard and has consistently put quality first. As a result, we’re grateful that Charlotte-area residents entrust us with their oral health. We know firsthand how successful endodontic treatment offers relief from pain. This is why we are so passionate about saving our patients’ natural teeth!

Contact us today to schedule your consultation.