It can often be difficult to make an accurate endodontic diagnosis when patients present with tooth pain. We want to be able to get clear results from diagnostic testing so we can feel confident in our treatment recommendations.

One of the things I know to be true for my office and for many of our offices is the challenge of getting clear endodontic diagnostic information. One of the things that can cloud our diagnosis is the effect of over-the-counter medications.

To get accurate endodontic information, the patient must not take pain medication or anti-inflammatory medication in the 8 to 10 hours before you are doing your diagnosis. So, we need to ask patients if they have taken any Tylenol, Advil, or Aleve. We also need to think of patients who are taking nonsteroidal anti-inflammatories on a general basis. These are patients who are not taking them for the tooth but on a routine basis for other reasons such as arthritis.

If I am going to refer the patient to an endodontist and they are going to continue the diagnostic process, I want to coach the patient to not take any pain medication or anti-inflammatory medication for about 8 hours before that appointment. Otherwise, they may not be able to provide the accurate information needed for an accurate diagnosis and most appropriate treatment.

This is something I have passed on to the team members who answer the phone and schedule appointments in my practice. When someone calls to schedule an appointment to diagnose their discomfort, we tell them to do us a favor and not take any more pain medication or anti-inflammatory medication before we see them. Ideally, any of these drugs will be out of the patient’s system before the patient arrives.

Note that your patients who suffer from chronic inflammatory pain conditions such as bursitis, arthritis, and fibromyalgia are often prescribed anti-inflammatory medications that are long-lasting, for example, Celebrex and Meloxicam. These drugs are taken every 24 hours, so their effects last longer and pose a greater risk of clouding a pulpal diagnosis.