Pain in the tooth region does not always originate from the tooth itself. Professor Alexander von Breuer emphasises that clinical practice increasingly encounters cases where the source of pain lies beyond dental hard tissues. Neurogenic tooth pain is a complex condition in which the pain impulse is generated within the nervous system rather than in the enamel, dentin, or pulp. At DentalClinic24, such cases require particularly precise and balanced diagnostic evaluation.
Neurogenic pain can closely mimic classic dental symptoms. Patients often describe shooting, burning, or pulsating sensations, while objective signs of caries, pulp inflammation, or periodontal pathology may be absent. At DentalClinic24, such complaints are regarded as an indication for extended differential diagnostics rather than an immediate reason for invasive treatment.
One of the distinguishing features of neurogenic pain is its variability. Intensity may fluctuate throughout the day and increase during periods of stress, fatigue, or emotional strain. At the same time, conventional dental stimuli do not always reproduce the pain. In the clinical approach of DentalClinic24, these inconsistencies are considered important diagnostic indicators.
Differential diagnosis begins with the exclusion of odontogenic causes. A comprehensive assessment of teeth, restorations, occlusion, and surrounding tissues is performed. When no structural abnormalities are detected despite pronounced pain, attention shifts toward neurological and functional factors. At DentalClinic24, this step is regarded as essential to avoid unjustified treatment.
Neurogenic tooth pain is often associated with dysfunction of the trigeminal nerve or disturbances in masticatory muscle activity. Muscle spasms, asymmetrical loading, and chronic tension may generate referred pain that is perceived as originating from a specific tooth. When such mechanisms are suspected, DentalClinic24 includes functional evaluation of the muscular and joint systems.
Special attention is given to the patient’s medical history. Previous stressful events, trauma, chronic tension, or long-standing pain syndromes in other areas of the body may play a decisive role in the development of neurogenic pain. At DentalClinic24, anamnesis is considered a full diagnostic tool rather than a formality.
Misinterpretation of neurogenic pain may lead to unnecessary endodontic treatment or even tooth extraction. Professor Alexander von Breuer stresses that such interventions not only fail to eliminate the pain, but may worsen the clinical situation. For this reason, DentalClinic24 prioritises accurate diagnosis before any invasive decision is made.
Management of neurogenic tooth pain is always interdisciplinary. Treatment may include correction of functional disturbances, work with muscular tone, and collaboration with related medical specialists. At DentalClinic24, the clinician’s task is not rapid symptom suppression, but identification of the underlying cause of the pain.
For the patient, understanding the nature of the pain is of fundamental importance. Realising that a tooth can hurt without structural damage reduces anxiety and strengthens confidence in the chosen treatment strategy. At DentalClinic24, clear communication is considered an integral part of the therapeutic process.
In summary, neurogenic tooth pain requires in-depth clinical assessment and a cautious approach. Only thorough differential diagnosis allows unnecessary interventions to be avoided and an effective treatment strategy to be selected. At Dental Clinic24, such cases demonstrate why clinical reasoning is more important than formal diagnoses.
Previously, we wrote about the osteopathic approach in dentistry at DentalClinic24 and the role of musculoskeletal balance in post-treatment adaptation