- Evidence of dentin exposure (gingival recession, loss of enamel)
- Sensitivity or pain on tactile examination of suspected teeth
- Evaporative stimulus: Suspected tooth is isolated using cotton rolls. If a momentary blast of air from air/water syringe causes sensitivity. It can confirm DH
- percussion sensitivity
- Pain lingering after the stimulus is removed
- Vitality tests to rule out pulpal involvement
- Radiographic examination to check for caries, pulpal or periodontal involvement
- Signs of fractured, leaky or poor restorative margins.
Reference: Clinical operative dentistry-principles and practice : Ramya Raghu, Raghu Srinivasan
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