Case reviews in pain| Volume 9, ISSUE 9, P767-770, September 2008

Toothache or Trigeminal Neuralgia: Treatment Dilemmas

      A 61-year-old woman presented to her general dentist with a complaint of pain associated with the maxillary left first premolar. The patient described a sharp, lancinating pain that was triggered by stimulation of the tooth in question. She also reported 2 specific episodes in which she experienced severe, shooting electrical shock-like pain followed by a hot sensation in the same area. One of these episodes was triggered by a cool breeze on her face and the other occurred while washing her face. Examination and radiographic assessment revealed a periapical osseous lesion resulting in a diagnosis of acute apical periodontitis. Nonsurgical endodontics was completed with no undue effects.
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