Atypical odontalgia

What is atypical odontalgia?

Atypical odontalgia is a rather unknown disease. The name used to apply to them Phantom pain, however, atypical odontalgia is a serious dental disease. It is noticeable through permanent neuropathic pain and should be treated in any case.

The pain can persist for years and severely restrict those affected in their everyday life. In addition, the diagnosis is not easy and usually takes a long time.

You might also be interested in this: Facial pain

These symptoms can indicate atypical odontalgia

Atypical odontalgia is often associated with constant pain. This is often felt as dull pressure pain. But short or sharp pains can also occur at irregular intervals.

Patients can often sleep at night and feel no pain at this point. The pain usually begins a little later after the dental treatment and can persist for several years.

Another indication of atypical odontalgia is persistent pain even after the previous illness has healed and no clear signs of inflammation.

More information is available here: The causes of toothache

Possible causes of atypical odontalgia

One of the possible causes of atypical odontalgia can be "Deafferentation of the peripheral trigeminal nerves " (Trigeminal nerve = facial nerve) belong. Here, the nerves are so irritated by dental treatment that the transmission of the impulses is disturbed and the signal transport is interrupted.

Read more about the topic here: The trigeminal neuralgia

This results in over- or under-reactions at the nerve endings and spontaneous activity can trigger pain in the corresponding supply area of ​​the nerve. Especially when a tooth is removed (extraction), a surgical intervention in the jaw area, a root tip resection or a root canal treatment, atypical odontalgia can result. However, it is very rarely observed.


Since there are no clinical or radiological findings for atypical odontalgia, the diagnosis is a challenge for the dentist. The exact cause of the pain can often not be found out. This is a Exclusion diagnostics, this is very important in order not to misdiagnose early on. In addition to the dentist, a visit to an internist and a neurologist can also be helpful.

Treatment of atypical odontalgia

Atypical odontalgia is a diagnosis of exclusion, which unfortunately is very tedious in many cases. The patient's patience and cooperation are therefore very important for a successful therapy. There are various treatment options for atypical odontalgia.

  • First, drug-based therapy should be attempted. This is where tricyclic antidepressants such as Amitriptyline® used.
  • Injection therapy with a vasoconstrictor-free local anesthetic is also possible to eliminate the pain. Find out more about the topic here: Dental pain elimination
  • In addition, should Capsaicin in the form of an ointment help with nerve pain.
  • Another form of therapy is pain psychological therapy. This therapy is carried out by a psychotherapist who specializes in pain diagnostics.
  • There are also some relaxation therapies that can alleviate the symptoms. Patients learn to cope with the pain and no longer to be permanently affected by it in everyday life. Read about it too: How can you reduce stress?

A causal therapy, i.e. to eliminate the cause of the pain, is unfortunately not possible, as the exact cause cannot be determined.

These drugs can help

Drug therapy for atypical odontalgia includes tricyclic antidepressants such as Amitriptyline®. These are administered in low doses. So they only work against the pain and not on the psyche. By giving the medication, the pain should be perceived as less severe and thus provide relief.

In addition, capsaicin can be applied to the affected area several times a day in the form of an ointment. Capsaicin is said to relieve nerve pain and promote blood circulation.

Can atypical odontalgia be cured?

Complete healing of atypical odontalgia is associated with a long duration of therapy. Nevertheless, it is possible that the patients are and remain symptom-free after successful therapy. Many patients already feel a little better after starting therapy, as the various forms of therapy gradually lead to symptom relief. It is important not to stop the therapy early or to interrupt it for a long time.

Duration of complaints

Since atypical odontalgia is a diagnosis of exclusion, it will take a long time before the exact diagnosis can be made. Relief gradually occurs during therapy. Complete healing of atypical odontalgia can take up to several years. The combination of drug therapy and relaxation therapy can have a positive effect on the duration of treatment.

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