Endodontic pain can be difficult to diagnose and manage. Many times, the patient presents with vague and diffuse pain with multiple teeth that are painful and respond abnormally to endodontic testing. This is because odontogenic pain can act as a powerful trigger for increasing parafunction. The increased parafunction then leads to myofascial pain which can be quite severe. Conversely, parafunction can act as a trigger for odontogenic pain.