Establishing an accurate diagnosis (both pulpal and periapical) is the most important step in determining the appropriate treatment (Berman and Hartwell, Pathways of the pulp, 11th ed. Mosby/Elsevier, St. Louis, 2–39, 2011; Schweitzer, Gen Dent 57(6):560–567, 2009). If an incorrect diagnosis/assessment of the clinical findings is made, improper management may result often leading to confusion, for example, performing endodontic treatment when it is not needed or providing some other treatment when root canal treatment is indicated. Tooth pain is usually considered the worst and least tolerable kind of pain. It usually originates in dentine, pulp, or periapical tissue and is thus considered of endodontic origin. Therefore, 90% of all patients with orofacial pain require a thorough endodontic assessment and diagnosis, and 60% of them may require endodontic treatment. A proper diagnosis is only possible following the subjective description of complaints by the patient coupled with objective clinical findings. Identification of a coronal or radicular fracture is also important. Although this is not specifically a pulpal or periradicular diagnosis, but it is important to note that fractures may change the proposed treatment plan. Temporomandibular joint (TMJ) dysfunctions may also present as dental pain, so we should keep in mind the clinical presentation of patients with those symptoms as well.