The Pattern of Odontogenic Referred Pain

Background: Referred odontogenic pain (RP) is a phenomenon that is seen regularly in dentistry and it is not extensively understood. It can make formulating a proper diagnosis difficult and its presence can lead to inappropriate treatment. Methods: 250 patients experiencing odontogenic pain within the dental clinics of West Virginia University were surveyed. The survey inquired about the patient’s biographical information, medical history, characteristics of the pain, the presence and location of RP, and the psychosocial effects of the pain. Additionally, the endodontic diagnosis of the offending tooth was determined by a member of the endodontic department. The collected data was then statistically analyzed via chi-square test, binary logistic regression, t-test, and ANOVA. Results: Statistically significant associations were developed with the presence of RP and a diagnosis of irreversible pulpitis (IP), as compared with pulp necrosis (PN), and the female gender, as compared with the male gender. Overall, 45.6% (114/250) of subjects experienced RP. Among those with RP, 68.4% had a pulpal diagnosis of IP and 30.7% had a pulpal diagnosis of PN. Subjects with RP reported an increased effect on their activity, sleep, mood, and stress on a DVPRS pain scale. Female subjects also reported an increased effect on activity, mood, and stress. Heat maps were generated for each tooth sextant. Conclusions: RP is more often associated with a diagnosis of IP and the female gender (as opposed to PN and the male gender, respectively). Increased psychosocial effects were found in subjects experiencing RP