Differential Diagnosis for Molar Pain
The following differential diagnosis is organized into categories to help guide the thought process:
- Single most likely diagnosis
- Cracked tooth syndrome: This condition is characterized by intermittent, fluctuating pain that often improves with chewing, as the pressure of chewing can temporarily stabilize the crack and reduce the pain.
- Other Likely diagnoses
- Dental caries: Tooth decay can cause pain that worsens with chewing or temperature changes, but the pain can be intermittent and fluctuating if the decay is not severe.
- Pulpitis: Inflammation of the tooth pulp can cause pain that is exacerbated by chewing or temperature changes, and the pain can be intermittent if the inflammation is reversible.
- Periodontal disease: Gum disease can cause pain that worsens with chewing or brushing, but the pain can be intermittent and fluctuating if the disease is not severe.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Dental abscess: A bacterial infection of the tooth pulp or surrounding tissue can cause severe, persistent pain that worsens with chewing or pressure, and can lead to life-threatening complications if left untreated.
- Osteonecrosis of the jaw: A rare but serious condition characterized by death of the jawbone, often associated with bisphosphonate use or radiation therapy, can cause severe pain and disability.
- Rare diagnoses
- Atypical odontalgia: A rare condition characterized by chronic, persistent pain in a tooth or teeth without any identifiable cause, can be intermittent and fluctuating.
- Eagle syndrome: A rare condition characterized by elongation of the styloid process, can cause pain in the face, neck, and jaw that worsens with chewing or swallowing.
- Trigeminal neuralgia: A rare condition characterized by sudden, severe pain in the face, often triggered by chewing, talking, or other facial movements.