Stacy was a patient with tooth pain that radiated from her lower right jaw. Her history showed that she, awhile back, had a filling in that location, which led to a root canal and crown, and then finally a tooth implant six years ago.
After a thorough examination, which included X-rays, there seemed to be no identifiable cause for the pain. The X-ray showed the entire root, including the nerve and blood vessels, had been removed to make room for the implant’s titanium post, which acts as the support for the tooth restoration or crown attached to its abutment. With a 98 percent success rate, implants have never been more popular. Overall, implants provide improved oral health with the look and feel of natural teeth.
But for Stacy, the aggressive and overwhelming “dental treatment” she needed for a natural smile and healthy teeth may have contributed to a condition known as Atypical Odontalgia, otherwise known as phantom tooth pain. This pain sometimes occurs after a root canal or a tooth extraction. But a recent study published by the Journal of the Minnesota Dental Association and supported by the National Institutes of Health estimates that of the 870,000 new cases wherein persistent oral pain was reported by patients, 550,000 of those cases were found to have no known identifiable reason patients continue to experience pain after corrective dental treatment.
Some professionals have even suggested that the sensation is often similar to what an amputee experiences. The pain is referred to as “atypical” because it’s quite different from pain that is felt from a typical toothache. Toothaches are aggravated by chewing or biting, or when the affected tooth comes into contact with hot or cold temperatures. Typical tooth pain has an identifiable source, such as decay or gum disease, unlike atypical or phantom tooth pain, which has no underlying cause.
For Stacy the tooth pain was a consistent ache with no tooth decay or periodontal disease. In some patients, just like Stacy, phantom tooth pain can spread to other areas of the face or jaw, and can occur without reason.
For many patients and dental professionals, this condition can be both a frightening and frustrating situation that can lead to more dental treatments that provide no effective pain relief. If a thorough history, clinical examination, and X-ray assessment fail to identify the source of the pain, a diagnosis of atypical odontalgia or phantom tooth pain may be appropriate.
What is Phantom Tooth Pain?
Currently, most clinicians treat phantom tooth pain with medication. According to the Academy of Oral Medicine, an antidepressant is used most often because of their pain-relieving properties. While medication has been helpful in pain reduction, it’s done little for eliminating the problem at its source.
While a definitive cause is yet to be found, what health professionals do know is that the condition may be caused by a variety of factors, such as sex, age, and genetic predisposition. In addition, the condition is more common in women than men, and more prevalent in people of middle age and older.
Researchers seem to point to a “short circuiting” of the nerves that carry pain sensations to the jaw and teeth. During scans such as a positron emission tomography (PET) or magnetic resonance imaging (MRI) areas of the brain show transmissions of nerve signals to the brain. These nerve signals appear to malfunction, and the result is a persistent pain sensation. In some cases, the pain is intermittent and spontaneous, ending just as quickly as it began.
There are no specific treatments for phantom tooth pain. But any of the following approaches can help when a flare-up occurs:
- Find ways to relax. Use meditation or rhythmic breathing to reduce muscular tension.
- Participate in fun activities. Distractions, like playing a board game or listening to music, can help relieve the mind.
- Stay active. It sounds counter-intuitive, but maintaining enjoyable hobbies such as swimming or even gardening burns calories and reduces emotional tension.
If the pain is persistent, talk to your dentist about other alternatives to relieve symptoms. During Halloween, and other seasons when sweets are abundant, take the focus off phantom tooth pain. With a little help, the only phantoms will be the ones trick or treating at your door. 
