The most common cause of intra-oral pain is dental disease. Inflammatory dental disease may be pulpal, periodontal or a combination of both. Symptoms generally resolve after dental therapy, but post-operative persistent pain can ensue. The clinical characteristics are intense, throbbing, poorly localized and generally provoked by stimulation of the offending tooth. There are occasions, where primary headache disorders like migraine or cluster headache pain are located in the lower half of the face and mimic acute dental disease.

The diagnosis of atypical facial pain is controversial. Atypical odontalgia (AO), which is considered a subcategory of atypical facial pain, is defined as a localized pain in a tooth or tooth site and is usually neuropathic. Pain from these neuropathic conditions may be confused with headache and are best evaluated with careful examination. In these cases, management is achieved through pharmacology, nerve block and sometimes surgical strategies.

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