Persistent Tooth Pain
In a small percentage of patients, toothache pain that develops spontaneously
and/or following mechanical dental intervention becomes persistent and
chronic. Subsequent attempts to address these "dental pains"
with root canal therapy and/or surgical techniques including extraction
also meets with failure.
Typically characterized by low grade constant ache that is nonresponsive
to analgesics or local anesthetic blockade, these pains have been assigned
a neurogenic origin. At times, these symptoms represent a pre-trigeminal
neuralgia condition, or a condition similar to post-amputation phantom
pain.
Once a diagnosis has been made, therapy is usually limited to specific
medication regimens or counterirritant strategies. Treatment is rather
specific, case to case, but in most situations, mechanical therapies are
avoided.
Also considered when postulating a diagnosis for persistent toothache
pains, are conditions related to vascular disorders (migraines), muscle
referral disorders, and intracranial lesions such as tumors.
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