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General product and research information only; not medical or dental advice. This page does not describe how to perform a test on a patient.
Short answer
Endo-Ice is a branded dental refrigerant spray whose listed ingredient is 1,1,1,2-tetrafluoroethane. Clinicians use cold sprays of this kind in pulp sensibility testing, one input into an endodontic diagnosis. In a 656-patient clinical study, Endo Ice had a reported sensitivity of 0.916 and specificity of 0.896; the test measures the nerve response of the pulp, not its blood supply.
What Endo-Ice is
Endo-Ice is made by Coltene/Whaledent. Its 2007 safety data sheet (SDS, Coltene part number 3P01845C) lists a single ingredient, 1,1,1,2-tetrafluoroethane (CAS 811-97-2), and describes a non-flammable aerosol that is a clear, colorless liquid under pressure, insoluble in water, with a spearmint odor, and containing no ozone-depleting chemicals. The same SDS lists no hazardous components. For how to read each section of an SDS, see the guide on how to read a safety data sheet.
How cold testing is used in diagnosis
A BMC Oral Health paper (Castillo-Silva et al., 2019) describes the cold test as a specific test of pulp sensitivity that forms part of endodontic diagnosis, and states that the diagnosis should be a synthesis of medical and dental history, clinical examination, specific tests and radiographic analysis. A cold spray is therefore one piece of evidence, not a diagnosis on its own. For the wider field, see what dental research covers.
Evidence on diagnostic performance
Three published studies bear directly on cold-spray testing. Each row below comes from the paper cited in the Sources section.
| Study | What was compared | Reported result |
|---|---|---|
| Jespersen et al., J Endod 2014;40(3):351-354 | Endo Ice and the electric pulp tester (EPT), 656 patients | Endo Ice: sensitivity 0.916, specificity 0.896, accuracy 0.904. EPT: sensitivity 0.84, specificity 0.74, accuracy 0.75. |
| Medeiros and Pesce, Rev Odontol Univ Sao Paulo 1997;11(3) | Ice stick and tetrafluoroethane, 594 teeth, patients aged 47-60 | Tetrafluoroethane gave a significantly greater number of confirmations than ice (p << 0.01). |
| Castillo-Silva et al., BMC Oral Health 2019;19:326 | 1,1,1,2-tetrafluoroethane cold test; 258 subjects, 320 teeth (160 vital, 160 necrotic); direct pulp inspection as the reference | Accuracy varied between subgroups, so a result from one subgroup should not be generalized to others. |
Jespersen and colleagues concluded that pulpal sensibility testing with Endo Ice and EPT are accurate and reliable methods of determining pulpal vitality. Castillo-Silva and colleagues list tooth disease, gender and age among the variables linked to false results.
Related pulp sensibility tests
The studies above compare cold sprays with two other approaches: the electric pulp tester, which Jespersen et al. tested in the same patients, and an ice stick, which Medeiros and Pesce compared with tetrafluoroethane. No ranking beyond those reported results is implied here.
Handling and storage facts from the SDS
For labs and clinics that keep aerosol stock, the 2007 SDS states the following. Treat it as one dated document and check the current SDS for the product in hand.
- Product is under pressure; do not puncture or incinerate the container.
- Do not use near ignition sources.
- Wear gloves and eye protection; the liquid may cause freezing or skin irritation.
- Store cool and well ventilated, and not above 120 F.
- Shipping entry in 2007: UN-1950, aerosols, non-flammable, class 2 (sea and air).
The general SDS-driven duties of a workplace are covered in the guide to the hazard communication standard in laboratories, and the history of the older sheet format in SDS vs MSDS. A practice-level supply list that includes dental items is in the dental office medical emergency supply checklist.
Common misunderstandings
A positive cold response means the tooth is vital
Castillo-Silva et al. state that the cold test evaluates the nervous response of the pulp and does not evaluate pulp vascularity, which is the indicator of vitality. A necrotic tooth can respond positively because vital nerve fibers can remain in the root canals, giving an incorrect diagnosis.
The spray alone produces a diagnosis
The same paper places the cold test inside a combined assessment of history, examination, specific tests and radiographs.
All cold agents perform alike
Medeiros and Pesce reported tetrafluoroethane gave more confirmations than ice in their sample, so the agent used is part of the result.
FAQ
What is Endo-Ice?
A Coltene/Whaledent refrigerant aerosol whose SDS lists 1,1,1,2-tetrafluoroethane as its ingredient, used for cold pulp testing.
Is Endo-Ice flammable?
The 2007 SDS describes it as a non-flammable aerosol, and also says not to use it near ignition sources and not to puncture or incinerate the can.
How accurate is Endo Ice?
Jespersen et al. (2014) reported sensitivity 0.916, specificity 0.896 and accuracy 0.904 in 656 patients, against 0.84, 0.74 and 0.75 for the electric pulp tester.
Sources
- Jespersen JJ, Hellstein J, Williamson A, Johnson WT, Qian F. Evaluation of Dental Pulp Sensibility Tests in a Clinical Setting. J Endod 2014;40(3):351-354. University of Iowa record. Date checked: 2026-10-31.
- Castillo-Silva BE et al. Diagnostic accuracy of three placement sites for the cold test in subjects amongst different age groups. BMC Oral Health 2019;19:326. doi:10.1186/s12903-019-0878-2 (PMC6700768). Date checked: 2026-10-31.
- Medeiros JMF, Pesce HF. Eficacia do bastao de gelo e do tetrafluoroetano na determinacao da vitalidade pulpar. Rev Odontol Univ Sao Paulo 1997;11(3). SciELO abstract. Date checked: 2026-10-31.
- Coltene/Whaledent, Material Safety Data Sheet, Endo Ice Refrigerant Spray, January 2007, P/N 3P01845C. OUHSC-hosted copy. Date checked: 2026-10-31.
