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Implications for Dentists

Background. Atypical odontalgia (AO) is a poorly understood and commonly misdiagnosed condition for which patients often undergo multiple unsuccessful dental or surgical procedures. The authors conducted a study to determine the prevalence and describe the characteristics of patients with AO seen at the University of Southern California Orofacial Pain and Oral Medicine Center (USC OFP-OM Center), Los Angeles.

Methods. The authors conducted a retrospective record review from a database of more than 3,000 patient records from June 2003 to August 2007 to identify patients diagnosed with AO.

Results. The authors identified 64 patients (44 women and 20 men) between the ages of 26 and 93 years as having a diagnosis of AO. Of those 64 patients, 71 percent initially consulted a dentist regarding their pain, and 79 percent had undergone dental treatment that failed to resolve the pain. The pain of 64 percent of the patients had no known cause.

Conclusions. Dentists, who often are the first health care providers to see patients with AO, must be aware of this condition and must follow the appropriate steps to determine its diagnosis.

Clinical Implications. Dentists and physicians should understand the implications and importance of early diagnosis of patients with AO and of referral to pain specialists for treatment.

Key Words: Atypical odontalgia; chronic trigeminal neuropathy; phantom tooth pain

Abbreviations: AO: Atypical odontalgia. • ENT: Ear, nose and throat. • OFP-OM: Orofacial Pain and Oral Medicine. • TMD: Temporomandibular disorder. • USC: University of Southern California. • VAS: Visual analog scale.