Hello, Cervical tilt can be seen in conditions like retroverted uterus, any pelvic infections or adhesions leading to mobilization of the uterus and cervix to one side, etc. Compared with normal position, this abnormal position of the cervix because of the leading cause can present with abdominal pain, dyspareunia, etc. Minimal pain can be dealt with analgesic drugs or/and antibiotics. In case of severe pain because of pelvic adhesions, etc. adhesiolysis may be needed. Regarding pap smear, nowadays liquid based pap smear is an alternative but in any of the method per speculum examination will be conducted usually. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Sree Gouri SR