To establish a differential
diagnosis for orofacial pain we must first
consider the history, examination and
relevant investigations.
Although both may co-exist,
the more rare non-dental pain must be
distinguished from dental pain to avoid
unnecessary dental treatment and to
organize appropriate referral for the
patient. It is essential that patients are
referred to the correct departments within
secondary or tertiary care to ensure the
most efficient management for patients
and to maximize use of NHS resources.
Pain history
A thorough pain history is
crucial and time needs to be taken when
taking it as it should provide sufficient
detail to guide clinicians to the most likely
diagnosis. It is also important to institute
relevant investigations.
In 1936, Ryle’s classic analysis of
pain highlighted 11 essential questions to
be included in the pain history1 and these
still apply today and have been further