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Dental pain from surrounding structures

Non-odontogenic pain is pain that is not associated with the teeth but involves other orofacial tissues. Non-odontogenic pain can be difficult to diagnose and can vary in severity. The following conditions can mimic pain from a toothache and may be the reason a patient presents to the dental clinic with pain.

Pain from Maxillary Sinus

Pain can originate from the maxillary sinus because there is only a thin plate of bone separating the maxillary teeth from the sinus; inflammation from the sinus lining from infections can lead to facial pain that can be felt in the teeth. This type of pain is a dull aching pain and may be exacerbated by bending over or lying down.

Pain from TMJ

Temporomandibular joint dysfunction syndrome (TMD) is a term used to describe some disorders affecting the temporomandibular joint, masticatory muscles, and other structures associated with this region. Common complaints from patients include pain in the muscles around the mouth, pain in the temporomandibular joint upon use, headache, earache, locking or clicking of the jaw, and tinnitus.

Pain from Neurovascular Structures

Non-odontogenic pain can also be of neuromuscular origin; examples include muscle tension headache, neck pain, whiplash, and fibromyalgia. Pain can be evident in the facial muscles and the neck may be tender, dysfunction of muscles may also be evident. Neurovascular pain refers to a group of disorders involving the trigeminal neurovascular system.

This condition is most often associated with headaches but can also involve infection or tumors; the pain occurs with headaches and usually subsides when the headache ceases. This type of pain may need a referral to a physician as in some cases can be life-threatening. Neuropathic pain can mimic toothache when it involves the nerve supply to the teeth.

This can be caused by trauma, inflammation, or tumors in the oro-facial region. Trigeminal neuralgia is very well-known in the dentistry field. Toothache-type pain may also be felt in the presence of oral cancer, and squamous cell carcinoma, occurring in the oral mucosa may present with pain and sensory problems.