Diagnosing Tooth & Jaw Pain
Not sure what’s causing your discomfort? We use advanced imaging and diagnostics to pinpoint the issue and offer real solutions — so you can feel like yourself again.
Diagnosing Tooth and Jaw Pain
Tooth and jaw pain is one of the most difficult categories of pain to diagnose accurately, and the reason is simple: pain doesn't always come from where it feels like it's coming from. A tooth that throbs may not be the tooth that's actually damaged. Jaw pain that mimics a toothache may be coming from a muscle, a joint, a sinus, or a nerve. Pain that has lingered for months after a previous dental procedure may not be dental at all. Getting the diagnosis right is the difference between treatment that resolves the problem and treatment that doesn't help, or worse, that addresses a tooth that was never the source.
Endodontists are the dental specialists trained specifically in diagnosing tooth pain, and that training matters. Studies have shown that pain perceived in the teeth can originate from the jaw muscles, the temporomandibular joint, the sinuses, or even nerve conditions far from the mouth. Without careful evaluation, a tooth in the line of fire of that referred pain can be mistaken for the source and treated unnecessarily. A meaningful portion of root canal procedures performed each year are done on teeth that were never the actual cause of the patient's pain. The first job of an endodontist is to make sure that doesn't happen.
At San Diego Center for Endodontics, diagnosis begins with a thorough conversation. Dr. Freer and Dr. Adams will ask detailed questions about when the pain started, what triggers it, what relieves it, how it has changed over time, and what makes it better or worse. Pain that is sharp and triggered by biting points to one set of possibilities. Pain that is dull, constant, and unchanged by chewing points to another. Pain that wakes you up at night, pain that radiates to the ear or temple, pain that shifts from tooth to tooth — each pattern carries diagnostic meaning.
The clinical examination follows. This includes pulp vitality testing to check whether the nerve inside a suspected tooth is healthy or compromised, percussion and bite testing to identify cracks and inflammation, palpation of the surrounding muscles and joint to rule out muscular or TMJ-related pain, and a careful inspection under magnification for cracks, decay, or restorations that have failed. 3D cone beam imaging is used when standard X-rays don't tell the full story. CBCT can reveal hidden cracks, missed canals from previous treatment, sinus involvement, and bone changes that flat X-rays cannot show.