Dental pain

Diagnosis

The diagnosis of toothache can be challenging, not only because the list of potential causes is extensive, but also because dental pain may be extremely variable, and pain can be referred to and from the teeth. Dental pain can simulate virtually any facial pain syndrome. However, the vast majority of toothache is caused by dental, rather than non-dental, sources. Consequently, the saying "horses, not zebras" has been applied to the differential diagnosis of orofacial pain. That is, everyday dental causes (such as pulpitis) should always be considered before unusual, non-dental causes (such as myocardial infarction). In the wider context of orofacial pain, all cases of orofacial pain may be considered as having a dental origin until proven otherwise. The diagnostic approach for toothache is generally carried out in the following sequence: history, followed by examination, and investigations. All this information is then collated and used to build a clinical picture, and a differential diagnosis can be carried out.