Odontalgia in vascular orofacial pain

A case of episodic, spontaneous odontalgia, aggravated by ingestion of cold food, with no apparent dental pathology is presented. Attempts as alleviat ing the pain by means of root canal treatment had failed in previous, simil ar episodes, and pain and pulpal hyperalgesia had shifted to other location s. Primary vascular orofacial pain was diagnosed and effective control obta ined by prophylactic treatment with propranolol, a beta-adrenergic blocker. A prophylactic attempt with nifedipine, a calcium channel blocker, failed to alleviate the pain. This diagnostic entity and possible therapeutic appr oaches are discussed.