February 3, 2010

Phantom Tooth Pain

Phantom tooth pain, or atypical odontalgia, is an oral health issue marked by persistent toothaches. These most often occur after dental work such as a root canal, filling, or tooth extraction. As the name implies, this type of tooth pain may be felt where there was once a tooth. The pain may start as an ache where a tooth had been, and it may spread to nearby parts of the mouth and face.

Root canal work may cause a tooth to become denervated. That is, the tooth’s nerve fibers fail or are lost. In the worst cases, the tooth pain may be classed as a dental emergency.

The tooth pain may be felt in the gums or in teeth that are present, too. Since the source of the pain is hard to pin down, patients may see more than one dentist to try to find relief only to be told there is nothing wrong with their teeth. Some dentists may take the converse stance and persuade patients to have one or more root canals, gum surgeries, or extractions to try to address the cause.

The Causes of Phantom Tooth Pain

Dental work is often not able to treat phantom tooth pain, though. This is due to the fact that the ache is not in the tooth or in the gums. It may be in a nerve that has been hurt by recent dental work.

Trauma to the face or the puncture of a needle may also cause phantom tooth pain. In some cases, the ache may grow to affect the central part of the nervous system, which senses tooth pain.

If at first no local source of infection or inflammation can be found, dentists may choose to do more work to try to find the source of the pain.

This work may include:

  • Cold testing of the affected teeth;
  • An x-ray to examine the teeth for change
  • A panoramic radiograph to search for signs of other problems
  • A full head and neck exam to rule out abnormality
  • A cranial nerve exam
  • An MRI imaging of the area

Treating Phantom Tooth Pain

If the pain is peripheral (comes from the part of the nerve nearest the tooth or gums), patients may find relief with local anesthetics or steroids. These help to curb nerve activity. Some find relief with medicated creams.

If, on the other hand, the tooth pain is central, daily oral meds may be used. These can include antidepressants and anti-seizure meds.