Orofacial pain often causes special difficulties to patients and dentists. Numerous differential diagnoses require the utilization of a coordinated diagnostic concept. Often, multiple causes lead to the need for a complex treatment plan. Impacted third molars are a potential cause of a variety of complications. Caries, pulp necrosis, and periapical infection are some of the infrequent causes of such pain. The presented case shows just such a constellation, resulting in primarily "unclear" orofacial pain. A diagnostic sequence generally leads to the correct diagnosis and thereby allows for fast and effective therapy. This shows how important structured diagnostics are, especially in cases of "unclear" pain.