Persistent Dento-Alveolar Pain Disorder (PDAP): Working towards a Better Understanding

Abstract

k e y w o r d s Non-odontogenic tooth pain, chronic tooth pain, atypical odontalgia, phantom tooth pain, review, diagnosis, epidemiology, mechanisms s u m m a r y p o i n t s • New terminology, persistent dento-alveolar pain disorder (PDAP), and diagnostic criteria have been put forward to address the shortcomings of existing nomenclature, which are associated with unclear criteria.• Arriving at an accurate diagnosis of PDAP is based on excluding other possible aetiologies, and may involve different care providers.• Synthesis of published data suggests that PDAP has a frequency of occurrence following root canal therapy of around 1.6%.• The putative risk factors involved in PDAP are largely unknown, but seem to be similar to those being identified with other post-surgical chronic pain disorders.• The underlying mechanisms involved in the development of and/or perpetuating PDAP are unknown and the approach to treatment remains empiric in nature.

AAE and AAOMR Joint Position Statement

“…An example is persistent dentoalveolar pain also known as atypical odontalgia. (14) The diagnostic yield of conventional intraoral radiographs and CBCT scans was evaluated in the differentiation between patients presenting with suspected atypical odontalgia vs. symptomatic apical periodontitis, without radiographic evidence of periapical bone destruction. (15) CBCT imaging detected 17% more teeth with periapical bone loss than conventional radiography.…”

Healthcare pathway and biopsychosocial impact of persistent dentoalveolar pain disorder: a qualitative study

“…Persistent pain following deafferenating dental procedures is a known outcome with an estimated frequency of 1.6% (Nixdorf & Moana-Filho 2011). This type of pain has been reported in the literature since the 1750s (Hunter 1803) and has been recognized to exist under a variety of different names including atypical odontalgia, phantom tooth pain and persistent idiopathic facial pain (Lascelles 1966, Harris 1974, Campbell et al 1990, Graff-Radford & Solberg 1992, Marbach 1996, Glennon et al 2004, Baad-Hansen 2008.…”

Acute and chronic pain in orofacial trauma patients

“…Persistent pain as a result of trigeminal nerve injury in the oral and perioral areas has been described by many terms such as atypical odontalgia, 27 atypical facial pain, 28 and more recently, persistent dentoalveolar pain disorder, 29 and painful post-traumatic trigeminal neuropathy (PTTN). Persistent pain as a result of trigeminal nerve injury in the oral and perioral areas has been described by many terms such as atypical odontalgia, 27 atypical facial pain, 28 and more recently, persistent dentoalveolar pain disorder, 29 and painful post-traumatic trigeminal neuropathy (PTTN).…”