Differential Diagnosis for Toothache
- Single most likely diagnosis
- Dental caries or tooth decay: This is the most common cause of toothache, 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 if it progresses to the point of affecting the tooth's support structures.
- Dental abscess: A localized collection of pus in the tissues surrounding the tooth, often resulting from an untreated infection.
- Cracked tooth syndrome: A condition where a tooth has a crack that can cause pain upon chewing or when exposed to temperature changes.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Trigeminal neuralgia: A chronic pain condition that affects the trigeminal nerve, which can cause intense, shock-like or stabbing pain in parts of the face, including the teeth.
- Temporomandibular joint (TMJ) disorder: While not typically life-threatening, severe cases can lead to significant morbidity and should be considered, especially if the pain is associated with jaw clicking or locking.
- Osteomyelitis of the jaw: A bone infection that can be severe and requires prompt treatment to prevent serious complications.
- Sinusitis: Infection or inflammation of the sinuses can refer pain to the upper teeth and should be considered, especially if accompanied by other symptoms like nasal congestion or facial pressure.
- Rare diagnoses
- Eruption cyst: A rare condition where a cyst forms over an erupting tooth, which can cause pain and swelling.
- Odontogenic keratocyst: A type of cyst that can develop in the jaw and cause tooth displacement or resorption, potentially leading to toothache.
- Multiple myeloma or other malignancies: Although rare, these conditions can cause toothache among other systemic symptoms and should be considered in the differential diagnosis, especially in patients with a history of cancer or unexplained systemic symptoms.