By: Lee Ann Brady DMD
Topic Originally Appeared on PankeyGram.Org. Dr. Brady granted permission for igniteDDS to share with our readers.
Endodontic diagnosis is critical to proceed with a successful treatment plan. Therefore, an accurate pulpal and periapical diagnosis should be made by combining clinical and radiographic examinations.
Evaluate Patients Systemically
We must evaluate patients systemically since the diagnosis cannot be made just from the local examination and the tooth pain. Systemic factors, like medications, can sometimes interfere with symptoms and make it difficult to make an accurate endodontic.
We want to be able to get clear results from diagnostic testing so we can feel confident in our treatment recommendations.
Effect of Nonsteroidal Anti-Inflammatory Medications
To get accurate endodontic information, the patient must not take pain medication or anti-inflammatory medication in the 8 to 10 hours before you are doing your diagnosis.
Since these medications will mask inflammatory symptoms. So, we need to ask patients if they have taken any Tylenol, Advil, or Aleve. We also need to think of patients who are taking nonsteroidal anti-inflammatories on a general basis.
These are patients who are not taking them for the tooth but on a routine basis for other reasons such as arthritis.
Coaching when Referring
If I am going to refer the patient to an endodontist and they are going to continue the diagnostic process, I want to coach the patient to not take any pain medication or anti-inflammatory medication for about 8 hours before that appointment.
Otherwise, they may not be able to provide the accurate information needed for an accurate diagnosis and most appropriate treatment.
This is something I have passed on to the team members who answer the phone and schedule appointments in my practice. When someone calls to schedule an appointment to diagnose their discomfort, we tell them to do us a favor and not take any more pain medication or anti-inflammatory medication before we see them.
Ideally, any of these drugs will be out of the patient’s system before the patient arrives.
Patients Who Suffer from Chronic Inflammatory Conditions
Note that your patients who suffer from chronic inflammatory pain conditions such as bursitis, arthritis, and fibromyalgia are often prescribed anti-inflammatory medications that are long-lasting, for example, Celebrex and Meloxicam. These drugs are taken every 24 hours, so their effects last longer and pose a greater risk of clouding a pulpal diagnosis.
Special attention should be given to patients with chronic inflammatory conditions like arthritis, bursitis, or fibromyalgia. These patients often take medications such as Celebrex or Meloxicam every 24 hours, and their effect lasts longer, posing a greater risk of clouding a pulpal diagnosis.
Key Takeaways
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