Atypical odontalgia--a form of neuropathic pain that emulates dental pain.
In order for the neuropathic pain associated with AO to occur in the oral or facial area, a deafferentation process must be initiated as previously explained. Deafferentation happens when there is a trauma to tissues including, but not limited to, endodontic therapy, a surgical extraction or even a simple one, a deep scaling, an injurious dental injection, and even the placement of a crown. Thankfully, most patients heal uneventfully. Apparently a small percentage of patients have a genetic predisposition to deafferentation pain. In reviewing articles on this subject, there is often material about the inadvertent dental treatment of patients with AO. Many patients often have undergone numerous invasive procedures in an effort to ameliorate pain. It is not possible to read a research paper about AO without reading about the recurrent theme of either overtreatment or unnecessary treatment. Caution should be exercised when performing endodontic therapy solely for the relief of pain without objective need for such therapy. It is common for the AO patient to undergo many other irreversible dental treatments with no resolution of pain symptoms. When the dentist encounters a patient in pain for which there is no dental connection, he or she should strongly consider referring the patient to a facility or practitioner who has expertise in dealing with the non-dental source of dental pain.
Markman
Stanley
S
Department of Oral Medicine, Division of Diagnostic Sciences, UMDNJ-New Jersey Dental School, NJ, USA.
Howard
Jennifer
J
Quek
Sam
S
D003937:Diagnosis, Differential; D005156:Facial Neuralgia / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D008487:Medical History Taking; D014098:Toothache / Q000175:diagnosis*