Linguistic Cues in the Diagnosis of Acute Suppurative Apical Periodontitis: An Analysis of Verbal Information and Clinical Experience

Onizuka C, Kaiho Y, Nagamatsu H and Sera M

Published on: 2025-08-12

Abstract

Background: In dental diagnostics, clinical decision-making is primarily grounded in oral examinations and radiographic imaging. Nevertheless, verbal information obtained during the medical interview is also believed to contribute meaningfully to diagnostic inference. Despite this, the interpretive criteria for such verbal cues remain insufficiently defined.

Objective: The present study aimed to elucidate how dentists utilize and interpret patients’ verbal expressions in the diagnosis of acute suppurative apical periodontitis (ASAP), and to investigate whether such interpretative patterns vary according to clinical experience.

Methods: A total of 259 dentists participated in a survey evaluating 25 patient-reported symptoms, each assessed for its diagnostic relevance to ASAP.

Results: The findings identified several verbal expressions as supportive of an ASAP diagnosis, including: “I cannot chew things,” “I was in pain last night and couldn’t sleep,” “I have treated the same tooth before,” “The pain is throbbing,” and “My gums are swollen.” Conversely, the statement “My tongue feels numb” was frequently regarded as incongruent with an ASAP diagnosis.

Comparative analysis based on years of clinical experience revealed statistically significant differences in the interpretation of 13 out of the 25 verbal cues.

Conclusions: These results suggest that specific verbal expressions can serve as supplementary diagnostic indicators for ASAP. Moreover, experienced practitioners appear to develop a more nuanced ability to selectively interpret such information, reflecting a progressive acquisition of diagnostic expertise. Given the variability in symptoms associated with ASAP-depending on the stage of inflammation and the anatomical site-these findings underscore the necessity for integrative diagnostic reasoning that incorporates both verbal and non-verbal data in clinical assessments.