Toothaches are classified into dental and non-dental causes
When a toothache occurs, it is natural to go to the dentist first, but some toothaches are not caused by dental problems.
While odontogenic causes are certainly caused by the teeth, non-odontogenic causes often involve lesions in tissues outside the mouth. “Many diseases of the oral cavity can cause toothache, such as caries, endodontic disease, periapical disease, periodontal disease, pericoronitis, etc., which are generally easy to diagnose clearly. However, toothache caused by non-oral diseases should be carefully identified based on the patient’s symptoms, combined with the patient’s general condition and relevant examinations.” Weng said that non-dental toothache includes toothache symptoms caused by lesions of the maxillary sinus, temporomandibular joint, eye, ear, nose, salivary gland and other adjacent organs; neuropathic pain, such as trigeminal neuralgia, pterygopalatine neuralgia, linguopharyngeal neuralgia; and systemic diseases, such as toothache caused by diabetes, heart disease, hysteria, etc.
In general, the clinical characteristics of non-dental toothache, such as spontaneous toothache, but insensitive to hot and cold stimuli; regional toothache, which does not involve the whole mouth; persistent and periodic toothache, and constant in nature. Especially when clinical examination cannot find the focal tooth and conventional dental treatment cannot relieve the pain, it can be considered whether the toothache is of non-dental origin.
Toothache of different etiologies
Odontogenic pain usually has more typical symptoms and is easily diagnosed clearly. In contrast, non-dentogenic toothache has diverse and often atypical manifestations, which can be easily missed and misdiagnosed. So, let the experts teach you how to initially identify –
[Odontogenic pain]
1, pulpitis pain: the typical pain symptom of acute attack is spontaneous nocturnal pain, with paroxysmal episodes, and the pain will increase when encountering hot or cold stimulation, and because the pain cannot be localized, it often cannot accurately point out the location of the diseased tooth by itself.
2, periapical pain: acute attack is spontaneous, persistent pain, the pain is aggravated by the stimulation of occlusion, the diseased tooth can be clearly localized.
3, the tooth hidden crack pain: mainly manifested as the tooth bite object will suddenly appear a transient soreness, teeth bite something feel weak, but the crown appearance is intact, dental problems are not easily visible to the naked eye, cracks need to be detected with the help of special light irradiation, staining.
4, wisdom tooth pericoronitis pain: the onset is mostly in youth, often induced after staying up late, drinking, fatigue. Mainly pain is felt around the back teeth, and it also affects mouth opening and swallowing.
Periodontal abscess pain: Sudden appearance of periodontal swelling, pustules, also accompanied by bad breath, pain is persistent, severe cases may have fever.
Non-dental toothache]
1.Temporomandibular joint disorder: individual cases will have symptoms similar to toothache, also accompanied by dull pain and local pressure pain in the muscles around the joint.
2.Facial myofascial pain syndrome: like toothache and muscle pain, in many cases, the specific site of pain cannot be pointed out, and there is often no abnormality in dental examination.
3, pharyngeal inflammation: if suffering from pharyngeal inflammation with toothache, it may not be a dental problem that causes trouble, this involved pain can radiate to the ear, and it is aggravated when swallowing, mostly dull pain. At this time, the oral mucosa is often diffusely congested, and the lymphatic follicles in the posterior pharyngeal wall are hyperplastic.
4. Trigeminal neuralgia: it has special electric shock-like characteristics, lasts for several seconds, and the pain is reduced or disappears at night, and is not related to temperature stimulation. At this time, dental examination does not reveal any problem, and even tooth extraction cannot solve the pain.
5, cardiogenic pain: mainly manifested as toothache symptoms do not match with oral examination, mostly occurring after intense exercise or exertion. The pain is insensitive to stimulation, periodic, and the pain can radiate to the back of the shoulder and arm, which can affect the rescue if not detected in time, and can be seen in myocardial ischemia, angina pectoris, aortic coarctation and other diseases.
6, oral and maxillofacial herpes zoster: clinically, it can also show symptoms of toothache, often they can not determine which tooth pain, oral examination can not find the disease teeth, mostly manifested as burning-like, pinprick-like pain. Examination reveals clusters of small blister-like lesions or vesicular surfaces on the oral mucosa and facial skin, with a band-like distribution along the nerve course. The residual pain after the rash is a pins-and-needles pain that can last for several months or longer.
Special reminder that toothache symptoms can be caused by a variety of reasons and require a thorough examination by a medical professional to make a correct diagnosis in order to avoid misdiagnosis and missed diagnosis. Therefore, while having toothache and receiving local treatment in dentistry, it is important to provide the doctor with the general health condition to facilitate the timely detection of non-dental diseases.