When a patient is in pain and in your chair, they seek your expertise to alleviate their immediate problem. Diagnosis is often straight forward, but what about when it isn't? Frequently there are multiple layers of pain clouding our testing and judgment. It is important to get it right, and there is no topic more fraught with downside than an incorrect diagnosis. In this interactive discussion, we will dive into complex diagnostic situations and strategies to get it right and serve our patient population. Solving our patient's immediate pain builds trust and is an integral part of comprehensive dentistry.