The Pain Game: Diagnostics in Dentistry

By Rebecca Stone August 7, 2019

When a patient comes to you in pain, the source of the problem is not always easy to pin down. Diagnosis of the pain may be difficult because the patient may be uncertain of its exact location, and palpation, percussion, thermal testing, and X-rays don’t always identify it. But because myriad conditions can result in dental pain, such a case can turn into a real head scratcher.

Fortunately, ever-evolving detection technologies may be the answer. In fact, the global dental diagnostic and surgical equipment market is expected to exceed more than $9.5 billion by 2024.1

Light and Magic

Good diagnostics often boil down to improved visualization. Although a two-dimensional (2D) X-ray may not reveal the source of pain, a three-dimensional (3D) one just might. Cone beam computed tomography (CBCT) is regarded by many in dentistry to be a real game changer. Offering views of dental structure from various angles, it facilitates a more comprehensive diagnosis.2

Even simple boosts in lighting and magnification can work wonders. For instance, transillumination, in which a light is shone through a tooth, will differentiate healthy from damaged tooth structure. Some devices used for transillumination are also capable of taking pictures that can be shown in real time and stored in patients’ records.2

Other kinds of light-based technologies may facilitate early diagnoses. For example, caries detection devices are available in a range of technologies, some laser-based and others LED-based, using fluorescence to differentiate healthy from carious tooth structure.2

Optical coherence tomography (OCT), a developing technology in dentistry, uses near-infrared light via a hand-held scanner to produce radiological-type 3D images sans radiation. It can be helpful in detecting fractures, early demineralization, oral cancers, and assessing periodontal health.2,3

Other Measures

For evaluating pulp vitality, electronic pulp testers (EPT) can be used to check the sensibility of teeth via a mild electrical current. Care must be taken as an injured tooth may temporarily lack sensibility, leading to a misdiagnosis.2

Another method, laser doppler flowmetry (LDF), measures blood flow noninvasively, using a diode laser light transmitted by a fiber optic probe. While proving to be reliable and noninvasive, opinions are divided on the use of LDF in dental applications due to technique and environmental sensitivity.2

Pulse oximetry, a noninvasive way of measuring oxygen saturation in blood, is potentially useful in the field of endodontics for evaluating pulp vitality. The problem is that to date, no suitable sensor has yet become commercially available for dental applications.2

Oral cancer detection devices have been rather controversial due to the risk of false positives. Nonetheless, clinicians still view these devices as another weapon in their arsenals against oral cancer. Strides are also being made in genetic screening, which may ultimately make many dental conditions easier to diagnose, and salivary testing to detect oral and systemic diseases.2

Making Testing Easy

No matter what kind of diagnostic tests you’re performing, it is often helpful to isolate the tooth in question. Isolite 3, designed around a flexible mouthpiece, is not only easy to place, but provides isolation, retraction, suction and even extra illumination. And because the mouthpiece doubles as a throat shield, there’s no need to worry about accidental aspiration. And when you’re trying to solve dental mysteries, it might be nice to have at least one less thing to worry about.

A plethora of technologies are becoming available to help practitioners uncover sources of dental pain. By taking advantage of such tools, you can make your life — and those of your patients — a whole lot easier. 



  1. Market Research Engine. Dental Diagnostic and Surgical Equipment Market By Product Analysis (Dental systems and equipment, Dental radiology equipment, Dental lasers); By End Users Analysis (Hospitals, Dental clinics) and By Regional Analysis – Global Forecast by 2018 – 2024. Available at: Accessed April 5, 2019.
  2. Stone R. Hide and seek. Mentor.2018;9(4):30–34.
  3. Evans JW, Tadakamalla P. Clinical applications for optical coherence tomography. Decisions in Dentistry. 2016;2(5):14–16.