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Last updated: October 3, 2025View editorial policy

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Differential Diagnosis for Tooth Pain

  • Single most likely diagnosis
    • Dental caries or tooth decay: This is the most common cause of tooth pain, resulting from bacterial breakdown of tooth enamel.
  • Other Likely diagnoses
    • Pulpitis: Inflammation of the dental pulp, which can be reversible or irreversible, often caused by deep decay, trauma, or infection.
    • Periodontal disease: Infection of the gums and bone supporting the teeth, which can cause pain, especially when chewing.
    • Tooth fracture or crack: A broken tooth can expose the pulp, causing pain, especially with temperature changes or chewing.
    • Gingivitis: Inflammation of the gums, which can cause pain, especially during brushing or flossing.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Dental abscess: A bacterial infection that can spread to other parts of the face and skull, potentially life-threatening if not treated promptly.
    • Trigeminal neuralgia: A chronic pain condition that affects the trigeminal nerve, which can cause severe, shock-like pain in the face, including the teeth.
    • Osteomyelitis: An infection of the bone, which can occur in the jaw and cause severe pain, swelling, and potentially life-threatening complications.
  • Rare diagnoses
    • Eruption cyst: A rare condition where a cyst forms over an erupting tooth, causing pain and swelling.
    • Odontogenic keratocyst: A rare type of cyst that can occur in the jaw, causing pain, swelling, and potentially destructive to surrounding bone.
    • Multiple myeloma: A type of blood cancer that can cause tooth pain, especially if there are lesions in the jawbone.
    • Sickle cell disease: A genetic disorder that can cause tooth pain due to vaso-occlusive crises affecting the blood vessels in the jaw.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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