Differentiating Between Symptomatic Irreversible Pulpitis and Trigeminal Neuropathic Pain: Assessment of a Novel Method for Collecting Data on the Temporal Patterns of Pain

Abstract

Orofacial pain is a common experience and can prove diagnostically challenging. Symptomatic irreversible pulpitis (SIP) and trigeminal neuropathic pain (TNP) are two such conditions that prove difficult to distinguish for many clinicians. Commonly used diagnostic methods relying on clinical signs, symptoms, and the results of therapeutic trials may fail to identify TNP when it is present. A relatively unstudied aspect of orofacial pain conditions is the timing of painful symptoms. We piloted a novel method for the chairside collection of data on the temporal qualities of each condition and analyzed how easily people were able to provide the data, and what differences exist for SIP and TNP. All 35 subjects were able to provide the requested data with no or minimal assistance, and through their plots we were able to identify trends that may aid in differentiating between SIP and TNP. We also showed that clinical experts, using data collected from individual subjects, are able to differentiate between SIP and TNP. We conclude that further development of an easy to administer tool would serve as a useful aid in diagnosis of many pain conditions.