Differential Diagnosis for Tooth Pain with Direct Pressure
- Single most likely diagnosis
- Reversible pulpitis: This condition is characterized by tooth pain in response to stimuli, such as pressure, and is often caused by dental caries, tooth decay, or other irritants. The absence of visible signs of infection or inflammation supports this diagnosis.
- Other Likely diagnoses
- Irreversible pulpitis: Similar to reversible pulpitis but with a higher likelihood of progressing to necrosis if left untreated. The pain pattern can be variable, including pain on pressure.
- Cracked tooth syndrome: A condition where a tooth has a crack that can cause pain when pressure is applied, often due to the flexing of the tooth structure.
- Dentin hypersensitivity: While typically associated with sensitivity to temperature or sweet stimuli, some cases may present with pain on pressure due to exposed dentin.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Acute apical periodontitis or abscess: Although no visible signs of infection are noted, an abscess could be forming beneath the gum line or in the bone, which would require urgent dental attention to prevent serious complications.
- Osteomyelitis: An infection of the bone that could present with pain on pressure and might not have overt signs of swelling or redness in its early stages.
- Rare diagnoses
- Eruption cyst or pericoronal abscess related to an impacted tooth: These conditions could potentially cause localized pain, although they would typically be associated with some visible signs or symptoms related to the impacted tooth.
- Neoplastic conditions: Rarely, a tumor could cause tooth pain by exerting pressure on the surrounding structures, though this would be an uncommon presentation.