Differential Diagnosis for Dental Pain

Dental pain can be caused by various conditions, and a thorough differential diagnosis is essential for accurate diagnosis and treatment. The following categories outline the possible causes of dental pain:

• Single Most Likely Diagnosis
  • Dental caries (tooth decay): This is the most common cause of dental pain, resulting from bacterial infection and acid production that damages tooth enamel and dentin.
• Other Likely Diagnoses
  • Pulpitis: Inflammation of the dental pulp, often caused by deep caries, trauma, or infection, leading to pain and sensitivity.
  • Gingivitis or periodontitis: Inflammation of the gums (gingivitis) or supporting structures of the teeth (periodontitis), which can cause pain, swelling, and bleeding.
  • Dental abscess: A localized collection of pus in the tissues surrounding the teeth, often caused by bacterial infection, leading to severe pain and swelling.
  • Cracked tooth syndrome: A condition where a tooth is cracked, causing pain and sensitivity, often when chewing or biting.
• Do Not Miss Diagnoses
  • Acute apical periodontitis: A condition where the tissues surrounding the root of the tooth become inflamed, causing severe pain and potentially leading to more serious complications if left untreated.
  • Dental trauma: Trauma to the teeth or surrounding tissues, which can cause pain, swelling, and potentially lead to more serious complications, such as tooth avulsion or fracture.
  • Trigeminal neuralgia: A condition characterized by sudden, severe facial pain, often triggered by stimulation of the trigeminal nerve, which can be mistaken for dental pain.
  • Sinusitis: Inflammation of the sinuses, which can cause referred pain to the teeth and face, often mistaken for dental pain.
• Rare Diagnoses
  • Odontogenic tumors: Rare, benign or malignant tumors that originate in the teeth or surrounding tissues, which can cause pain, swelling, and other symptoms.
  • Eruption cyst: A rare condition where a cyst forms over an erupting tooth, causing pain, swelling, and discomfort.
  • Dentinogenesis imperfecta: A rare genetic disorder that affects the development of tooth dentin, causing discoloration, sensitivity, and pain.
  • Eagle syndrome: A rare condition where the styloid process or ligaments become elongated or inflamed, causing pain and discomfort in the face, throat, and teeth.