Atypical odontalgia, also known as atypical facial pain, phantom tooth pain, or neuropathic orofacial pain, is characterized by chronic pain in a tooth or teeth, or in a site where teeth have been extracted or following endodontic treatment, without an identifiable cause. Over time, the pain may spread to involve wider areas of the face or jaws.
The pain is called “atypical” because it is a different type of pain than that of a typical toothache. Typical toothache comes and goes and is aggravated by exposure of the tooth to hot or cold food or drink, and/or by chewing or biting on the affected tooth. There is an identifiable cause, such as decay, periodontal disease, or injury to the tooth and the pain is predictably relieved by treatment of the affected tooth.
With atypical odontalgia, the pain is described as a constant throbbing or aching in a tooth, teeth, or extraction site that is persistent and unremitting, and which is not significantly affected by exposure to hot or cold food or drink, or by chewing or biting. The pain may or may not be relieved by the injection of local anesthetic. The intensity of the pain can vary from very mild to very severe. There is typically no identifiable cause to explain the pain and it often follows or is associated with a history of some type of dental procedure such as having a root canal or tooth extraction. On occasion, the pain can occur without any reason. The pain is felt in a tooth or teeth and persists in spite of treatment aimed to relieve the pain such as a filling, a root canal, or even an extraction. This often presents a frustrating and confusing situation for both the patient and the dentist, and can lead to more and more dental treatment, none of which is effective at relieving the pain.
The diagnosis of atypical odontalgia is made after a thorough history, clinical examination, and radiographic assessment fail to identify a cause for the pain. Once the diagnosis is made, medications can be used in an effort to reduce the level of pain.
QUESTIONS AND ANSWERS ABOUT ATYPICAL ODONTALGIA
Q: Why doesn’t dental treatment cure the pain?
Q: How is atypical odontalgia treated?
Q: Is this a permanent condition?
Q: Why doesn’t my dentist know about this problem?
Prepared by D Falace and the AAOM Web Writing Group
This information is not a substitute for professional medical advice, diagnosis, or treatment. If you have or suspect you may have a health concern, consult your professional health care provider. Reliance on any information provided in this monograph is solely at your own risk.