Referred Pulpal Pain with Atypical Features in an Endodontically Treated Tooth due to Learned Phenomenon

Pulpal pain does not refer to an endodontically treated tooth. Nevertheless, such a potential may exist based on a learned phenomenon due to previous treatment experiences but is rarely reported. Further, it is seldom reported to occur with atypical features. This case report is on a patient who was presented with pain in endodontically treated lower first molar (36) and recommended to undergo retreatment. However, endodontic treatment in 26 relieved the pain showing occurrence of referred pulpal pain in 36. But due to atypical referral and unknown endodontic status in 36, only uneventful follow-up confirmed the retrospective diagnosis of referred pulpal pain in 36. Pulpal pain can refer to an endodontically treated tooth based on learned phenomenon. Such a referral can also occur with atypical features and pose a diagnostic dilemma. Therefore, referred pulpal pain should be considered in the differential diagnosis of pain in an endodontically treated tooth.