standard-title Atypical Odontalgia

Atypical Odontalgia

What is atypical odontalgia?

There are several other more common names for atypical odontalgia that you may have heard before. Atypical odontalgia is also known as atypical facial pain or neuropathic orofacial pain. The new term used to describe this is now Persistent Dentoalveolar Pain, or PDAP. But phantom tooth pain is the most referred to name for this condition.

This condition is characterized by chronic pain in a tooth or multiple teeth. It can also occur in a site where teeth have been extracted or following endodontic treatment. In each case, there is no identifiable cause for your pain. Unfortunately, over time, the pain may also spread to include wider areas of your face or jaws.


Why is the pain atypical?

Well, that is because it is a different type of pain than a typical toothache. When you experience a typical toothache, the pain comes and goes. It is also aggravated by exposure of the tooth to hot or cold food or drinks. It can also be aggravated by chewing or biting on the affected tooth. In this instance, the pain has an identifiable cause including decay, periodontal disease or injury to the tooth. This pain is predictably relieved by treatment of the affected tooth.

The opposite is the case for atypical odontalgia. This pain is atypical because there is no identifiable cause for the ache. Often described as a throbbing or aching pain in a tooth, teeth or extraction site, it is persistent and unremitting. However, that pain is not significantly affected by exposure to hot or cold food or drink as well as not by chewing or biting.


Typical journey patients have gone through

Does this sound like you? Have you had a filling, or a root canal done and weeks, months or years later you still have a dull constant pain that does not improve with pain medications? Over time the pain gets unbearable or frustrating, leading to multiple different dentist or doctor visits. At times a root canal, in an effort to help with your pain, is performed with limited to no improvement.

Additionally, a retreat or apical root surgery is performed (apicectomy) with no change in symptoms. Then, the tooth gets extracted or several adjacent teeth get root canals followed by extraction. It sounds like a jumbled mess. You may also have been told that the reason is your missing teeth, so an implant is placed. But the pain gets worse and sometimes that tooth is removed again. The more work you get done in that area, the more your pain level increases over time. While you continue to search for an answer and hit a wall.


How do you treat atypical odontalgia?

Relief can be found with the injection of local anesthetic, but that is not always the case. And because there is no identifiable cause to explain the pain, it is important to review your clinical history to see if you had a dental procedure such as a root canal or tooth extraction. But there is still a chance the pain occurred without any particular reason, which can be frustrating.

In fact, this pain in your tooth or teeth can persist even when treatment aimed at relieving the pain is performed, including a filling, root canal or extraction. The diagnosis typically is made after completing a thorough clinical history and examination as well as if radiographic assessment fail to identify a specific cause for the pain. Once a diagnosis is made, though, medications can be prescribed to help reduce the level of pain you are experiencing. While treatment is successful in reducing the pain, it may not eliminate it completely.

Atypical odontalgia is not a rare condition, but it is not commonly understood by many dentists if they are not familiar with it. When a dentist has advanced training in craniofacial pain, they can better meet your needs. At Craniofacial Pain and Dental Sleep Center of Georgia, Dr. Mayoor Patel has the advanced training and understanding needed to diagnose and treat atypical odontalgia. Contact us today to learn more.

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