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Electric Pulp Test (EPT)

Pulpal Test

Overview

Function

The EPT test is a helpful test to assess pulp’s health and vitality.

Armamentarium 

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Video

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Procedure

Before you begin: select which teeth you will be testing. 


It is helpful to test 3-4 teeth at a time: a tooth on the opposite side of the mouth from the symptomatic side/tooth, a tooth on either side of the tooth of interest, a tooth opposing the tooth of interest, and the tooth of interest.


  • Every situation is different, so you will need to adjust your selection based on your patient’s symptoms and natural dentition

  • Ideally try to select control teeth that have similar anatomy or restorations (consider crown materials, size/location of restorations) to the tooth of interest

  • Give each tooth a number and ask your patient to compare “tooth number 1, 2, and 3” at the conclusion of the test

  • It is recommended to end with the tooth of interest in case there is any lingering discomfort

  • Note: Previously-treated teeth or teeth with crowns will not have a response to the electric pulp test. It is not recommended to use these as your control teeth

Explain the procedure to your patient. Their participation is necessary for accurate interpretation of results. Be sure to instruct your patient to raise their hand when they feel any sensation on their tooth.


For example: you might say, “I’m performing a test with this special probe on a few of your teeth now, and will be putting a minty toothpaste on a few of your teeth to help with the test. You may eventually feel a tingling sensation on that tooth. When you feel that sensation, I want you to raise your hand. As soon as I remove the tester the sensation will go away, right away. Do you have any questions?”


  • Note: some EPT may require the patient to hold onto part of the device. Be aware of how your electric pulp test functions and explain to the patient what they must do for the test to be successful

  • If the grounding component hangs from the lip, explain to the patient that the cold metal piece you are hanging is part of how the test works and will not be bothersome

Dry the patient’s teeth using gauze or a cotton roll. Do not spray the teeth using an air syringe as that may cause sensitivity.

Place a small amount of toothpaste or fluoride gel to act as a conductor onto the tip of the electrode.

Then, place the tip of the electrode against the buccal/facial surface of the tooth you are testing.

If your patient has a response to the electric current and raises their hand, remove the electrode immediately. This is a positive response and indicates that the pulp is responsive and most likely vital. Record the results in a record-keeping table.


  • Note: certain electric pulp tests have an increasing number on its screen. A positive response at a high number could indicate a false positive test, so it is important to compare the response to controls.

If your patient has no response to the electric current, remove the electrode. This is a negative response and indicates that the pulp is necrotic. Record the results in a record-keeping table.

Repeat this test until all of the control teeth and the tooth of interest have been tested. You should replace the toothpaste or fluoride gel onto the tip of the electrode prior to testing each tooth.

Remove any excess toothpaste or fluoride gel from the teeth.

References:

Torabinejad M, Fouad A, Shabahang S. Endodontics: Principles and Practice. 6th ed. London, United Kingdom: Elsevier, 2020.

Blicher B, Pryles RL, Lin J. Endodontics Review: A Study Guide. Hanover Park, IL: Quintessence Publishing Co, Inc, 2019.