Atypical Odontalgia: a Non-odontogenic Toothache of Neuropathic Origin

Pain as a presenting symptom often has multidimensional qualities including sensory, cognitive, discriminate and affective qualities. Pain in the orofacial region represents a diagnostic challenge for even an astute practitioner due to the complex mechanism in which odontogenic and nonodontogenic pain may simulate each other. Patients presenting with atypical odontalgia (AO) complain of toothache often in absence of any relevant clinical or radiographic findings. No definite diagnostic criteria or treatment guidelines are yet available for management of such a condition. Among the current hypothesis available regarding the pathophysiology of AO, the most relevant one describes it as a neuropathic pain condition. Another important related factor that should be taken into consideration in such cases is the psychogenic background of the patient. This review describes the clinical presentations of atypical odontogenic pain and suggests the need to establish the accurate diagnostic criteria for identification and outline the treatment algorithm which focuses more on patient counselling and avoidance of invasive approach