Why Should Your Endodontist Conduct a Cold Test for Root Canal Pain?

Patients often ask about the diagnostic tests we perform to make sure we understand what’s happening with your teeth. Since the tooth’s root system is tiny and complex, we use a variety of diagnostic tests to help identify the source of the pain. One of the simplest—and most powerful—is the cold test. Good news: if your dentist or endodontist performs a cold test, root canal pain may soon be left in the past.

Keep in mind this article is simply for the purposes of patient education. Dentistry and endodontics are complex fields requiring highly individualized care. It isn’t a substitute for dental care.

What is a Cold Test?

A cold test is one of the most useful diagnostic tests an endodontist may perform. Sadly, some dentists overlook its value, but it’s one of our favorites here at Ballantyne Endodontics. It’s such a simple test that ultimately may save you money, time, and future pain.

As a diagnostic tool, it helps pinpoint the source of the pain or sensitivity you’re experiencing, so you can see why we love it so much!

We use specialized Endo Ice to perform cold tests since it is effective and controlled.

The method for a cold test in dentistry is:

• Your dentist or endodontist applies a cold spray to an applicator like a Q-tip.
• Your dentist or endodontist then holds the Q-tip on a tooth for 5-10 seconds.
• Your dental professional assesses the resulting sensations (which may include tingling, discomfort, or nothing at all), including the duration of the sensation.

Even if you do experience discomfort, it will only last a few seconds, and it will help your dental professional determine the source of your sensitivity or pain. We can determine whether pulpal inflammation could be present, or assess for other concerns. 

In the case of endodontics, knowledge is power. The more we know from our diagnostic tests, the more we’re able to provide effective treatments, save your natural teeth, and relieve any pain you may be in.

Your Cold Test for Root Canal Pain Can Reveal a Lot!

The results from a cold test sometimes provide the answers your endodontist seeks. Responses to cold testing vary spending on the issue:

• A normal response — when a patient has healthy pulps, they respond to the test by experiencing a short-lived, sharp pain that subsides when the test is over. This indicates the nerve fibers are responsive.
• A prolonged response — the patient experiences a lingering response to testing. This is a sign of pulpal inflammation. The intensity and duration must be considered so your dental provider may ask additional questions or perform more tests to get to the bottom of your concern.
• No response — if a patient doesn’t respond to cold, then the nerve supply to that tooth is diminished. This may be a sign of pulpal necrosis or in previously root-treated canals.

If you’re feeling a bit uneasy about anticipated pain or discomfort from the tests, that is normal. As mentioned, temporary pain is a healthy and natural response to a cold test. 

However, through these tests, your dental professional can better identify the cause of your pain, how severe the damage is, and the best treatment to provide long-term relief for the patient. We know you have it in you to get through this test!

What are Some of the Other Diagnostic Tests Endodontists May Perform?

In addition to reviewing your history and imaging, your endodontist may perform other diagnostic tests.

Some of these tests include:

• Percussion testing — your endodontist, may tap on selected teeth.
• Electric pulp testing (EPT) – your endodontist will first clean and dry the tooth and then use a battery-operated device to pass a safe, low voltage current through it.
• Selective anesthesia – this test may sometimes be used to pinpoint referred pain or generalized pain. It can otherwise be difficult to tell where the pain is truly coming from.
• Visual exam – Your endodontist will look for signs of infection, facial asymmetry, awkward bite, or other symptoms.
• Vital pulp testing – there are various ways your endodontist may test pulp vitality, including a cavity test and the electric pulp test, which was already mentioned.
• Bite tests – Your dental professional may perform various tests to assess your bite.

If your dentist or endodontist takes the time to perform diagnostic tests like a cold test, then you may be in good hands. After all, your diagnosis is the basis of all the treatment planning and procedures that follow.

Questions an Endodontist May Ask in Addition to Cold Testing

Be sure to discuss your pain details with your dental care providers. Your endodontist may ask questions before or after cold testing, such as:

• “Is the pain localized or more generalized?” (As in, is it concentrated in one spot, or is it more all-over?)
• “Does the pain linger after exposure to cold and/or hot?”
• “Does the sensitivity cause you to avoid cold beverages or foods?”
• “Have you noticed swelling? If so, where?”
• “Are you sensitive to pressure like biting down?”
• “What symptoms do you experience?”
• “When did the pain start, and what situations seem to make it worse?”
• “Have you had any recent treatments such as crowns, fillings, or a root canal?”

Sometimes a patient’s reaction to cold testing can uncover a difficult diagnosis, pinpoint the true source of pain, and even expose damage or illness to teeth you didn’t realize was there.

Next Steps: Contact Your Dentist or Endodontist

If you have persistent discomfort or pain (or you were having pain and now you aren’t), or your dentist told you that you need a root canal, please consider seeing an endodontist. An endodontist is a highly trained dentist who specializes in root canals and saving natural teeth.

Since the root canal system is minuscule and complex, endodontists specializing in root canals tend to have more success than general dentists when performing root canals or retreatment. After all, it’s what we do all day, every day! We love our work and helping heal our patients.

At Ballantyne Endodontics, we have had the privilege of saving natural teeth and relieving pain for Charlotte-area residents.

We use the best diagnostic tools available, whether it is something as simple as a cold test for root canal pain, or highly sophisticated imaging tools. By staying on the cutting edge of endodontics, we deliver our patients the best likelihood of successful treatment and comfort.

We treat each patient holistically and individually. Ask your dentist for a referral or contact us to schedule a consultation.