A thought about differentiating between painful teeth
I had a good demonstration about how to manage a patient with painful teeth where pulp tests are ineffective. This generally means that the pulp is either too calcified to respond or the canal is necrotic or pulpless. In either of these situations, chances are there is some periapical involvement. A PA radiograph of TTP is a good sign of this. Also symptomatic questions are useful with a prolonged, intense dull pain which may wake the patient up at night. A way to approach this would be to get the patient to bite down on a cotton stick saying you're going to test the teeth and you want them to bite down with firm pressure on 3 teeth 1, 2 and 3 and to tell them afterwards which hurt the most 1, 2 or 3.