Sensitivity to percussion

Sensitivity (tenderness) to percussion is tested both vertically and horizontally. Several teeth must be tested in random order to get an understanding of how the patient reacts.

A mirror handle is used with only slight force to try to elicit a possible reaction from the patient. Sensitivity to vertical percussion is a sign of apical inflammation that is typically caused by acute apical periodontitis, but may also be caused by occlusal interference, vertical root fracture and rarely also by pulpitis. A negative test result does not necessarily mean the absence of inflammation.

Sensitivity to horizontal percussion can be caused by marginal periodontitis lateral periodontitis or vertical root fracture. However, the results of percussion tests must always be interpreted with caution.