Persistent Idiopathic Facial Pain — ORE Part 1 MCQ

Instant feedback + full explanation. One question, done properly.

HardOral MedicinePersistent Idiopathic Facial PainORE Part 1

A 40-year-old woman reports right-sided maxillary facial pain on most days for 6 months. It is dull, deep and poorly localised, without a clear trigeminal-nerve distribution. There are no trigger zones and toothbrushing, chewing and light touch do not provoke attacks. Clinical dental examination and appropriate dental radiographs show no pathology. What is the most likely diagnosis?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Persistent idiopathic facial pain

The diagnosis is **persistent idiopathic facial pain (PIFP)**. Its discriminating features here are pain on most days for more than 3 months, a dull/deep and poorly localised quality, absence of a discrete trigeminal distribution or trigger, and exclusion of odontogenic disease. UK specialist guidance notes that PIFP is often unilateral, can involve the upper jaw, and is constant or nearly constant without an identifiable dental cause. Trigeminal neuralgia instead causes brief, severe lancinating attacks, commonly triggered by touch, chewing or toothbrushing. Cluster headache is an attack disorder, typically with severe orbital/temporal pain and ipsilateral autonomic features. Sinusitis would require supporting sinonasal symptoms or signs. Irreversible pulpitis should produce localisable tooth-related symptoms and supporting clinical findings.

Reference: University College London Hospitals NHS Foundation Trust. Persistent Idiopathic Facial Pain, updated 19 March 2026. https://www.uclh.nhs.uk/patients-and-visitors/patient-information-pages/persistent-idiopathic-facial-pain