Abstract: This invention discloses a vitality-based photoplethysmography imaging (PPGI) system capable of determining the pulse frequency within the dental pulp, allowing for direct, accurate, real-time visualization of tooth vitality. The system comprises a transilluminating bitewing, capable of aligning and stabilizing a light source and an intraoral camera, which is operationally connected to a computing device that is equipped with video stabilization and digital signal processing algorithm (Pulp Assessment by Local Observation, i.e. PABLO) to assess pulp vitality via analyzing videos captured with the intraoral camera.