• The tooth to be tested and the adjacent teeth must be clean and dry. Interproximal
embrasures should be made free of any impacted food debris, saliva, water or plaque
by flossing or scaling with an instrument and air-drying before testing.
• It is often useful to electrically isolate the tooth being tested from its neighbors by
surrounding it with a clear mylar strip, such as those used in fabricating Class III
composite restorations.
• A dry cotton roll should be placed in the buccal vestibule to isolate the tooth from the lip
and cheek. A plastic mirror should be used to keep the tongue off of the tooth during testing.
• Metal or ceramic surfaces cannot be used as contact points for the pulp testing probes. Teeth
selected for pulp testing must possess enough exposed enamel or dentin to allow the probe to
make contact without contacting the gingiva or a metal restoration. In certain cases, this may
necessitate the use of the Precision Probe Set (available separately).
• Fully instruct the patient as to what you will be doing so they are not surprised during the test.
It may be helpful to avoid the use of the word “pain” in your instructions.
PULP TESTING PROCEDURE
1) Always use the Lip Clip and wire to ensure a complete electrical circuit.
2) Select the appropriate metal probe and insert it into the open end of the power unit (8).
3) To ensure good electrical contact between the probe and the tooth, apply a small amount of
toothpaste to the exposed tip of the metal probe.
4) Hold the unit in your hand so that the output control knob (9) is in close proximity to your
thumb. The indicator light (10) should be visible to you. The probe may be rotated to any
convenient angle.
5) Click the output control knob (9) to the “ON” position by turning it clockwise to activate the
unit. The indicator light (10) will begin to blink continuously, indicating that the Gentle Pulse
stimulus is ready to be applied to the tooth.
6) Set the dial to the lowest setting, and apply the probe tip to the middle of the labial or
lingual surface of the tooth being tested. Avoid soft tissue and restorations such as crowns,
amalgams or composites.
7) The power should be slowly increased by turning the output control knob clockwise until the
patient becomes aware of the stimulus. At the first sign of a response, remove the probe from
the tooth and make a note of the reading on the dial.
8) As a check of the reading obtained, a corresponding control tooth in the same arch should
be tested for comparison, if possible. Molars should be matched to molars, premolars to
premolars, cuspids to cuspids, and incisors to incisors. If this is not possible because teeth
are absent, endodontically treated, or have full coverage restorations, a similar tooth in the
opposite arch is always a better control than no control at all.
9) To preserve the battery, the device should be turned off immediately after use by rotating the
control knob counter-clockwise until a click is heard. Should the operator forget to turn the
power off, the instrument will shut itself off after 5-6 minutes. To reactivate the device after an
automatic shut off, simply turn off the device and turn it on again.
CLINICAL OBSERVATIONS
There are many factors that can affect the response of teeth to electric pulp testing. Among
these are patient age and gender, pain threshold, previous pain history, tooth trauma, presence
of pathology, use of prescription and non-prescription medications, or illicit drug use. In general,
thick teeth like molars require a greater stimulus than anterior teeth. Additionally, enamel will
require a greater stimulus than dentin or cementum.
It is impossible to prepare a “table of normal values” for pulp tester readings because
THERE IS NO “NORMAL” IN PULP TESTING. Rather, the clinician should perform
sequential comparisons between the subject tooth and the control tooth at consecutive office
visits, observing how the readings are changing as time progresses. By utilizing electric pulp