Atypical Facial Pain or Persistent Idiopathic Facial Pain, Atypical Odontalgia

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Overview

Atypical facial pain is a persistent, often hard‑to‑diagnose pain condition in the face that doesn’t fit typical patterns of dental, sinus, or neurological disorders. It can be constant, aching, or burning, and may require a thorough evaluation and individualized treatment plan to help identify underlying causes and provide relief.

Atypical facial pain, also known as persistent idiopathic facial pain (PIFP), is defined as chronic orofacial pain that is not very well defined, not well localized and diffuse, occurs in the absence of clinical neurological deficit and recurs daily for more than 3 months of duration. Pain can be intermittent or continuous, may start as unilateral and confined to one area but may become diffuse involving a larger area. The etiology of the pain is not clear. Some researchers have shown an association with injury to the trigeminal nerve, whereas others have suggested the pain to be of psychological origin. So, a thorough clinical assessment is very important in the diagnosis of this condition.

Atypical odontalgia also known as idiopathic toothache presents as pain in a tooth or in the area where a tooth was extracted. Literature has shown that 3-6% of the cases happen in patients with prior history of endodontic treatment. Pain typically presents everyday, almost continuous, may be confined to a localized area at the onset but may become diffuse and wide spread, and is not associated with any sensory loss. Pain can be accompanied by headache, hyperesthesia, allodynia etc. It is important to distinguish atypical odontalgia from tooth pain as both can present in the same area.

If you are experiencing atypical facial pain, schedule an appointment at North Dallas Dental Health for a thorough assessment and professional diagnosis by facial pain expert, Dr. Lakshmi Gorgantula.

 1.      Agostoni E, Frigerio R, Santoro P. Atypical facial pain: clinical considerations and differential diagnosis. Neurol Sci 2005;26(S2):s71–4.

2.      Melis M, Lobo SL, Ceneviz C, Zawawi K, Al-Badawi E, Maloney G, Mehta N. Atypical odontalgia: a review of the literature. Headache. 2003 Nov-Dec;43(10):1060-74.

3.      Campbell RL, Parks KW, Dodds RN. Chronic facial pain associated with endodontic therapy. Oral Surg Oral Med Oral Pathol. 1990;69:287-290.

4.      Headache Classification Committee of the Interna tional Headache Society. Classification and diagnos tic criteria for headache disorders, cranial neuralgias and facial pain. Cephalalgia. 1988;8(suppl 7):1-64.

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