ABSTRACT
There is significant debate in the field about the diagnosis and classification of persistent idiopathic facial pains. Myofascial trigger point pain is clearly under-recognized, and trigeminal neuropathies or “dysesthesias,” which many believe to be at fault for various atypical facial pains, are still inadequately understood. The chief complaint is a fairly constant, deep, dull, aching pain in a tooth or tooth site that is unchanging over weeks or months. It has some diurnal fluctuation, and usually worsens as the day progresses. The molars are most commonly involved, followed by premolars. Anterior teeth and canines are less frequently affected. The vast majority of patients present with unilateral pain, although other quadrants may become involved and other oral and facial sites may hurt. Despite persistent, often severe pain, there are typically no clearly identifiable clinical or radiographic abnormalities associated with atypical odontalgia.
