Dental Practice Triage for Persistent Pain after Dental Procedures: Recognizing Post-Traumatic Trigeminal Neuropathic Pain and Avoiding Unnecessary Retreatment

Persistent pain after dental procedures is often interpreted as odontogenic pain, treatment failure, temporomandibular disorder, or unexplained facial pain.This focused review aimed to propose a practical dental practice-based triage pathway for recognizing dental procedure-related post-traumatic trigeminal neuropathic pain (PTNP).Established diagnostic criteria, clinical phenotyping studies, trigeminal nerve injury assessment methods, and expert consensus on trigeminal nerve injuries were narratively synthesized.The pathway emphasizes early recognition of neuropathic warning symptoms, chairside sensory screening, exclusion of active odontogenic pathology, assessment of ongoing or surgically correctable mechanical causes, avoidance of unnecessary irreversible retreatment, and selective referral.Dental procedure-related PTNP should be considered when persistent pain is accompanied by sensory disturbance in a trigeminal nerve distribution.