Atypical Odontalgia: Unmasking the Phantom

Atypical odontalgia (AO) has traditionally been called “atypical facial pain” or “phantom tooth pain.” These are nonspecific descriptions. Dental odontalgias often present difficult diagnostic and treatment challenges. They may follow injury or deafferentation of trigeminal nerve fibers due to endodontia, dental extractions, implants, and oral surgery. The incidence may be 5% or more. Management is often poor and seldom involves interdisciplinary pain management, resulting in a worsening prognosis. Some of these orofacial neuropathies may be the result of neuroplastic changes and central nervous system sensitization. Understanding this is critical in avoiding failed treatments that may lead to further interventions and increasing pain.

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