I recently got a comment on my blog that some patients are denying the cold test every now and then. And I get it; it’s not fun.
But this is an absolute no-no, since this is one test you NEED to be super-certain on. Without doing this test, you cannot get a proper diagnosis, which could mean a misdiagnosis — or, even worse, the loss of your license!
You have to stand your ground and let your patients know that you are just trying to find the culprit tooth. Because if you don’t and you start treatment, it could be the wrong tooth and they will still have pain after the treatment.
Just warn your patient that the cold test is pretty sensitive and it is not going to feel great, but it gives you a lot of good information on where their pain is coming from. And remind them it only takes about 30 seconds, so it will be over in a jiffy.

A Quick Tip to Implement Immediately
This is probably the most economical quick tip I will ever give you:
Don’t EVER use a cotton applicator for your cold test!!

If you do, you will never elicit a real cold response. In fact, you may feel that all of your teeth are necrotic since it doesn’t get the tooth cold enough. It produces a false test result almost every time.
Instead, I want you to use a simple cotton pellet on a college plier.

But, it goes deeper than that. You need to feel your cotton pellet and make sure it has some give; the cotton pellet shouldn’t be too hard. The ones that are hard balls actually don’t hold your cold that well.
Make sure that cotton pellet gets SUPER saturated with that cold spray, like in this video:
We all have cotton pellets, so use them!!
Want more endo tips?
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-Sonia
Great tip
Thank you, Dr. Cummings!
-Sonia
Thank you. Please could you advise re how to cold test a tooth with a crown?
Hi Mohamed – Cold testing with a crown in place is really no different if there was no crown. I do recommend placing the cold cotton pellet as close to the crown margin as possible. One thing that I teach in Eschool is how to interpret your cold test because it really is so much deeper than just doing the cold test.
-Sonia
No wonder I got never get anything with cotton tip applicator and I started doubting endo ice . One of the assistant I worked with showed me a trick. Use the lid of a disposable needle and put water in it and small cotton tip applicator put in freezer u get a little popsicle it worked great. I love your tips.
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I’m so glad my newsletter and tips are helpful!
-Sonia