Nonodontogenic Causes of Toothache: A Case Series and Narrative Review

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Abstract Chronic orofacial pain is a complex and frequently misdiagnosed condition that significantly impacts individuals’ well-being. Accurately diagnosing orofacial pain can be challenging due to the overlap between headaches and orofacial regions. Patients who complain of tooth pain may actually be experiencing pain unrelated to dental issues. It is crucial for clinicians to accurately pinpoint the source and location of the pain to devise effective treatment plans. Nonodontogenic facial pain can stem from various causes such as musculoskeletal, neuropathic, or neurovascular issues. In addition, toothaches can result from conditions originating from other areas like systemic disorders related to the heart, nose, throat, or sinuses. Referred pain phenomena are acknowledged in the literature but are poorly understood, presenting significant treatment challenges. This is worrisome because such patients are more prone to developing chronic pain conditions, and invasive treatments may exacerbate their suffering and overall health. In the current review paper, three cases are detailed: one of myofascial pain, the second of trigeminal neuralgia, and the third of posttraumatic trigeminal neuropathy. In all three cases, dentists were the initial point of consultation as the pain was perceived in the teeth, resulting in unnecessary dental interventions. There remains a lack of knowledge regarding nonodontogenic toothache among clinicians. Increasing awareness of nonodontogenic toothache can help avoid unnecessary interventions and improve overall pain relief for patients.