Occlusal dysesthesia: a qualitative systematic review of the epidemiology, aetiology and management

Abstract

Occlusal dysesthesia refers to a persistent complaint of uncomfortable bite sensation with no obvious occlusal discrepancy. This systematic review aimed to draw a picture of such patients, to present an agreement of previously reported diagnostic criteria and to analyse the evidence level of the recommended management approaches. An electronic search for all relevant reports on occlusal dysesthesia was thoroughly performed based on previous nomenclatures (e.g. phantom bite, occlusal hyperawareness) in PubMed and The Cochrane Library in July, 2011. A total of 84 reports were matched, among which only 11 studies were included after a two-step (abstract and detailed full-text revision) screening process. Additionally, a thorough manual review of reference lists of the included reports enabled the inclusion of two additional studies. Data analysis revealed that 37 occlusal dysesthesia patients presented a mean age of 51.7 ± 10.6 years and were predominantly women (male/female: 1/5.1) with symptom duration of more than 6 years (average: 6.3 ± 7.5 years) and with concomitant psychological disturbances (e.g. mood disorders, somatoform disorders, personality disorders). Only four authors presented diagnostic criteria for occlusal dysesthesia, which served as the basis for an agreement in the diagnostic criteria. Treatment approaches included psychotherapy, cognitive/behaviour therapy, splint therapy and prescription of anti-depressants or anti-anxiety drugs. Classification of evidence level of management approaches, however, revealed that most of them were expert opinions with single- or multiple-case report(s). Future studies are necessary for a deeper understanding of the mechanisms behind the occlusal dysesthesia symptoms, and consequently, for improvements in evidence-based management approaches.

Psychiatric comorbidities and psychopharmacological outcomes of phantom bite syndrome

“…We found that PBS occurs predominantly in women and adults aged 30−70 years, with a peak in the 50s and 60s, supporting previous results [4].…”

“…Phantom bite syndrome (PBS) [1] also termed occlusal discomfort [2], or occlusal dysesthesia [3,4], is characterized by a persistent uncomfortable sensation of occlusions without an evident occlusal discrepancy. Affected individuals complain that their occlusion is "wrong," "somewhat high/low," or "the bite is off."…”

Phantom bite: a case report and literature review

“…The mean age of phantom bite patients is 51.744610.6 years, and the male/female ratio is 1 : 5.1. 3 Phantom bite patients report that their bite is off, meaning that they are unable to find a comfortable bite position. 4,5 These patients are preoccupied with their occlusion and constantly check their bites.…”

“…A recent systemic review of the literature provided the unified diagnostic criteria for phantom bite that is illustrated in Table 1. 3 A few etiological hypotheses for the symptoms of phantom bite have been provided. Marbach, 1 who was the first to coin the term ''phantom bite'' in 1976, proposed that schizophrenia, typically with paranoid features, underlies the condition.…”

“…This condition has subsequently been described in the literature under different names that include occlusal dysesthesia, occlusal neurosis, positive occlusal awareness, and occlusal hyperawareness. 3 Patients with phantom bite usually present with histories of repeated failed treatment attempts that have intensified their complaints and distress. These patients' excessive focus on their bite is one of the most obvious characteristic features of this condition.…”