Pulpalgia contributing to temporomandibular disorder-like pain: a literature review and case report.
BACKGROUND
Dentists need to be cognizant that temporomandibular disorder (TMD) -like pain can be caused by a tooth pulpalgia. The author provides suggestive symptom characteristics and definitive diagnostic techniques.


METHODS
A patient had severe bilateral TMD-like pain, which increased when something cold touched a premolar and when the patient lay down, and which awakened her several times every night. The author identified the offending tooth and administered a ligamentary injection along the tooth, which eliminated her bilateral TMD-like pain. Occlusal adjustment of her tooth reduced her pain, and subsequent endodontic therapy eliminated her pain. To the author's knowledge, this is the first report of a pulpalgia in a posterior tooth causing bilateral TMD-like pain.


CONCLUSIONS
Pulpalgia may cause symptoms that mimic TMD or may contribute to TMD signs and symptoms. When patients with TMD-like pain report feeling increased pain due to a cold stimulus' coming into contact with a tooth, practitioners should ensure that a pulpalgia is not contributing to their pain.
Wright
Edward F
EF
Department of Restorative Dentistry, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, Mail Code 7890, San Antonio, Texas 78229-3900, USA. WRIGHTE2@UTHSCSA.EDU
D003788:Dental Pulp Diseases / Q000150:complications*; D005260:Female; D006801:Humans; D008875:Middle Aged; D019558:Occlusal Adjustment; D053591:Referred Pain / Q000209:etiology*; D012390:Root Canal Therapy; D013706:Temporomandibular Joint Dysfunction Syndrome / Q000209:etiology*; D014098:Toothache / Q000150:complications*