Unexplained toothache: an evidence-based approach to diagnosis and management

This 'in my opinion' paper uses two case studies to highlight the importance of making an early diagnosis of unexplained orofacial pain. Patients with this condition can present with symptoms that can easily be confused with more common dental pain that is related to an organic pathology. An incorrect diagnosis can lead to invasive and irreversible treatment using advanced surgical or restorative techniques that are not evidence-based. Current evidence supports the use of non-invasive techniques such as behavioural interventions; for example, cognitive behaviour therapy. It is therefore imperative that patients with this condition are recognised early in primary care so that management is appropriate from the outset. This will prevent unnecessary invasive intervention, protecting the patient from harm and the practitioner from litigation.