Non-odontogenic toothache (atypical odontalgia) is a chronic pain in the tooth without obvious cause.
(1) The patient experiences continuous dental pain that is essentially unchanged for >= 3 months.
(2) The pain usually increases with chewing that involves the affected tooth.
(3) Hypesthesia is present with sensitivity to cold and a positive response to percussion.
(4) The dental radiographs are negative for visible pathology.
(5) There is a variable response to dental anesthesia with any relief lasting only the duration of the anesthetic.
(6) The patient may manifest psychological features such as depression or obsession about oral hygiene.
(7) A complete evaluation is negative for other causes of toothache such as sinus disease and temporomandibular joint disease.
Dental treatment of the tooth is not indicated since there is no pathology to treat. Management can be frustrating for both the patient and the dentist.
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