Symptoms
Probably the most important symptom of apical periodontitis is pain in the affected tooth. The treating dentist will tap the tooth before the treatment, because just then the irritated tooth nerves react quite violently (knocking pain). Theoretically it is quite easy to localize the inflamed tooth, but in practice it is more difficult, because the patients concerned usually feel a sensitivity to knocking in two or three adjacent teeth.
In an emergency, an X-ray (tooth film) provides information about the tooth to be treated. Most dentists always take an X-ray as soon as a patient with such severe toothache comes to the practice. In addition, a pronounced biting pain (pain when biting) is a relatively clear indication of the presence of an inflamed tooth root.
If there is a deep caries of the tooth and the vitality test, i.e. the reaction to a cold, is negative, this is also a clear sign of apical periodontitis. However, it is also possible that an inflammation of the tooth pulp (pulpitis) occurs in combination with an inflammation of the tooth root (apical periodontitis), in which case the vitality test will be positive. The result of the vitality test should therefore be treated with caution; it alone cannot provide any information about the treatment measures to be chosen.
