3. Scenario
Rachel presents today for her routine 6-month dental cleaning and
check-up. She is due for her routine bitewing x-rays. Upon greeting
Rachel she seems a bit concerned which is unusual for her personality.
You ask Rachel if she is having any problems with her teeth.
Hesitantly, she responds
“well, I have been having some pain on the top right.”
Your response is:
“what kind of pain and can you pinpoint which tooth?”
She responds a constant dull ache that is exacerbated by extreme
temperature change. She also points to her 2nd bicuspid.”
You explain to Rachel that she is due for her x-rays today and that they
will most likely show where the problem lies.
You take Rachel’s bitewing x-rays.
This is what is found!
4.
5. X-Ray Reading
Large radiolucent lesion seen on distal of #13
Appears to be located in interproximal region
Lesion appears to extend towards pulp
6. Diagnosis
Based on Rachel’s x-ray, what do you think is the most
likely cause of her pain?
Extensive decay causing nerve involvement and pulpal
exposure
7. Treatment
Root canal therapy, followed by post and core build up
completed with a porcelain crown to prevent fracture