Atypical odontalgia: An update

Abstract

Introduction: Atypical odontalgia (AO) is one of the most complicated challenges that a dentist can face for an adequate diagnosis and treatment plan. It can cause prolonged visits and costly overtreatments for the patient, increasing the time of resolution of the condition. Objective: To analyze the literature about AO, as well as its epidemiology, pathophysiology, predisposing factors, associated pathologies and treatment. Methodology: Information was searched in PubMed, SCOPUS and Google Scholar. Key words were used to search for information such as: atypical odontology, epidemiology, pathophysiology, related disease, treatment, among other relevant articles. Results: AO occurs in women (85%) and men (20%) between 50 -60 years old, hormonal or psychiatric disorders, related to local neuropathies due to problems in electrical conduction, and present or largely confused with trigeminal neuralgia and burning mouth syndrome mainly, sometimes it is possible to identify duct treatment or a history of aggressive therapy in the area, and can be treated with Amitriptyline, Imipramine, Aripiprazole, and locally with Botulinum Toxin A with favorable results found at 4 weeks. Conclusion: AO does not have specific characteristic criteria for its diagnosis, leaving a wide spectrum of possibilities that represent a complex pathology that needs further study.

Pharmacological Approach to Atypical Odontalgia Patients: A Systematic Review of Case Reports

“…The results showed that the drugs used in AO management consist of antidepressants, anticonvulsants, analgesic opioids, antipsychotics, and topical analgesics [5,37]. Drugs for neuropathic pain recommended by the IASP include TCA, gabapentin, pregabalin, Selective Serotonin Norepinephrine reuptake inhibitors (SNRIs) as the first line, while patch lidocaine, patch capsaicin, and tramadol as the second line [15].…”

“…Antidepressants, TCAs, such as amitriptyline and imipramine, are the most frequently used drugs with amitriptyline as the mainline agent if side effects or contraindications do not cause restrictions in their use [2,3,5,37,38]. The analgesic effect of TCA works with its primary mechanism of inhibiting the reuptake of serotonin and norepinephrine neurotransmitters.…”