Extraoral examination includes but is not limited to evaluation of facial swelling, sinus tract, and cervical or submandibular lymphadenopathy. All these signs are indications of infection. The source of infection should be determined.
Intraoral examination includes evaluation of hard and soft tissues and suspected tooth/teeth. Swelling and sinus tract should be noted. Draining sinus tract should be traced with gutta-percha point to its origin. Caries, discoloration, periodontal condition, and fracture or crack of the suspected tooth must be inspected. Types of restoration or defective restorations of the suspected tooth also have to be examined. Sensibility to palpation and/or percussion is an indicator of apical periodontitis of the suspected tooth. Mobility may be due to periodontal disease, root fracture, or apical periodontitis. Transillumination can be used to detect cracks or fractures of the crown. Caries may or may not cause painful pulpitis .