The following is all about the diagnosis of tooth pain differentiating a cracked tooth from a periapically infected tooth or periodontally infected tooth.
I call this topic cracked tooth syndrome as it is the most difficult to diagnose and takes the longest time to diagnose.
CRACKED TOOTH DIAGNOSIS HOW TO DIAGNOSE IF YOU HAVE A CRACKED TOOTH AS OPPOSED TO A TOOTH WHICH NEEDS A ROOT CANAL OR PERIODONTALLY DISEASED TOOTH.
Dr Lehmann has been in practice for over thirty years and would like to share with the public, her patients and others - her way of (differentially) diagnosing between a cracked tooth, a tooth which is PERIODONTALLY involved and a tooth which has had a nerve die in it due to decay etc leading to a periapical lesion at the root of the tooth causing a periapical abscess.
Below is a table of symptoms with the three conditions which have been simplified to "Cracked" for cracked tooth, VRF for vertical root fracture "Endo" for periapical lesion and abscess "Perio" for periodontal lesion The x axis will contain a list of signs and symptoms to quickly help to diagnose your condition.
This has been put together after a thirty plus years of clinical practice by Dr Lehmann in conjunction with the Article of American Association of Endodontists of Colleagues for Excellence Newsletter published June 2008 from which diagrams of teeth used.
The y axis shows the three conditions
The x axis
Patients with VERTICAL ROOT FRACTURES usually present with minimal signs and symptoms initially, so generally go unnoticed until the nerve gets infected (periapical pathosis) the vertical root fractures are difficult to diagnose as they mimic other conditions.
These are periodontal (gum) disease.
Failed root canal therapy.
Recommended treatment is exclusively extraction or removal of the cracked or fractured root.
Most VRF show a history of root canal therapy.
Dr Lehmann has twice seen cases where an untouched Virgin tooth has split down the centre and needed extraction.