Editing Toothache (section)

===Examination===
The clinical examination narrows the source down to a specific tooth, teeth, or a non-dental cause.  Clinical examination moves from the outside to the inside, and from the general to the specific.  Outside of the mouth, the [[Paranasal sinuses|sinuses]], muscles of the [[Muscles of mastication|face]] and [[Sternocleidomastoid muscle|neck]], the [[temporomandibular joint]]s, and [[cervical lymph node]]s are palpated for pain or swelling.<ref name=Hargreaves2011 />{{rp|9}} In the mouth, the soft tissues of the [[gingiva]], [[mucosa]], [[tongue]], and [[pharynx]] are examined for redness, swelling or deformity.  Finally, the teeth are examined.  Each tooth that may be painful is percussed (tapped), palpated at the base of the root, and probed with a [[dental explorer]] for dental caries and a periodontal probe for [[periodontitis]], then wiggled for mobility.<ref name=Hargreaves2011 />{{rp|10}}

Sometimes the symptoms reported in the history are misleading and point the examiner to the wrong area of the mouth. For instance, sometimes people may mistake pain from pulpitis in a lower tooth as pain in the upper teeth, and ''vice versa''. In other instances, the apparent examination findings may be misleading and lead to the wrong diagnosis and wrong treatment. Pus from a pericoronal abscess associated with a lower third molar may drain along the [[submucosa]]l plane and discharge as a [[parulis]] over the roots of the teeth towards the front of the mouth (a "migratory abscess"). Another example is decay of the tooth root which is hidden from view below the gumline, giving the casual appearance of a sound tooth if careful periodontal examination is not carried out. {{citation needed|date=April 2014}}

Factors indicating infection include movement of fluid in the tissues during palpation (''fluctuance''), [[cervical lymphadenopathy|swollen lymph nodes in the neck]], and fever with an oral temperature more than 37.7&nbsp;°C.{{citation needed|date=April 2014}}