What is the likely diagnosis for a patient with lower right posterior pain, insisting on extraction of vital teeth?

The presentation of lower right posterior pain along with a patient’s insistence on the extraction of vital teeth suggests an issue that is often misinterpreted. Trigeminal neuralgia is characterized by sudden and severe facial pain, typically in the areas served by the trigeminal nerve, and can often be triggered by everyday activities such as chewing or even light touches.

In this case, the specific complaint of pain localized to the lower right posterior area could stem from the trigeminal nerve’s involvement. The pain experienced in trigeminal neuralgia may lead patients to believe that dental extraction is necessary, particularly if they associate their pain with dental health, causing them to overlook other potential causes of the pain.

This condition can result in acute pain episodes, which might be mistaken for dental issues, thereby leading to the inclination to extract what appear to be vital and normal teeth. Therefore, the symptoms align well with trigeminal neuralgia, making it the most appropriate diagnosis in this situation.