Tooth pain accompanying cluster headache in a middle-aged female: a case report

Some orofacial pains (OFP) resemble primary headache disorders, but involve the trigeminal nerve V2 or V3 dermatome. The International Classification of Orofacial Pain (ICOP) distinguishes three types of such OFPs: Type 1 (facial pain in addition to headaches), Type 2 (facial pain replacing a previous primary headache), and Type 3 (OFP similar to primary headaches, without a history of headaches). This report describes a 46-year-old female patient with a chief complaint of toothache and severe pain radiating to the left orbital region, and with accompanying autonomic signs and symptoms. The pain persisted despite dental treatments, leading to a diagnosis of cluster headache. The OFP initially matched the Type 1 description, but later changed to match the Type 2 description. This case highlights the need to differentiate nonodontogenic from odontogenic pain for accurate diagnosis and treatment.