Differentiation of Unexplained Pain in the Intraoral Area

Abstract

  Nonodontogenic toothache is a condition characterized by pain in the oral cavity that is not caused by the teeth or periodontal tissues and for which no evidence of organic problems exists. The diagnosis of nonodontogenic toothache is known to be difficult, leading to misdiagnosis and overtreatment. Nonodontogenic toothache includes the following : 1. toothache arising from myofascial pain, 2. maxillary sinus pain, 3. cardiac toothache, 4. neurovascular toothache, 5. toothache arising from neuropathic pain, 6. persistent idiopathic toothache, and 7. toothache arising from psychiatric disorders or psychosocial factors. Recently, pain has been categorized as nociceptive pain, neuropathic pain, and nociplastic pain. Major nonodontogenic toothaches can also be differentiated according to these three categories of pain. In addition, burning mouth syndrome is considered to be a representative disorder of nociplastic pain. To differentiate unexplained pain in the oral cavity, the proper classification of pain must be understood and patients must be examined and diagnosed appropriately.