History taking
Record the presenting complaint in the patient's words, its chronology, relevant medical and dental history, medicines, allergies, social factors and expectations.
Understand
A useful history separates symptoms from interpretation: onset, site, character, triggers, duration, progression and prior treatment. Medical, medication, allergy, social and dental details alter diagnosis and safety.
Assess
Ask open questions first, then test hypotheses with focused questions. Identify red flags such as dysphagia, rapidly progressive swelling, unexplained weight loss or persistent altered sensation.
Apply
Document the patient's goals and the pertinent negatives as well as positives. If the story and examination disagree, pause and broaden the differential rather than treating the most obvious tooth.
Key distinctions
A pain history should ask whether symptoms are spontaneous, provoked, brief, lingering, nocturnal or associated with chewing; these patterns change the differential but never diagnose alone. Ask what treatment was already attempted and what changed afterward. Red flags should be documented as pertinent negatives when relevant rather than hidden behind a generic “systemically well”.
Think through a case
A patient points to the upper molar but describes seconds-long electric pain triggered by touching the cheek. That story broadens the differential beyond pulpitis before a tooth is treated.
The distinction to remember
Do not turn the patient's location of pain into a diagnosis. Referred pain and non-dental conditions can mislead even experienced clinicians.
Test your recall
What changes a differential most: the label “toothache” or the pain history?
Show answer
The pain's onset, site, triggers, duration and associated symptoms.