Tele Oral Medicine

Phantom and Persistent Tooth Pain

Phantom tooth pain or persistent toothache (atypical odontalgia) is a pain in the tooth or where a tooth once was after the completion of dental treatment. With this condition there is an underlying cause beyond dental pain that warrants investigation and treatment. 

Atypical odontalgia presents as a steady aching tooth, teeth, or extraction site with mild discomfort to severe pain. Dental local anaesthesia may relieve the pain in the short-term. Though there is generally no apparent cause for the pain, it is frequently related to a history of dental treatment. 

Signs and Symptoms:

Teeth affected with atypical odontalgia may have:

  • A constant dull, deep pain in the bone.
  • Sensitivity to touch.
  • No obvious dental pathology. 


A root canal, extraction, or other even minor dental procedures may produce atypical odontalgia. It is a nerve pain (neuropathic pain) condition, with nerve endings sending abnormal pain signals to your brain. These abnormal pain signals and processing between the nerves and the brain will not resolve without treatment. 


Atypical odontalgia can be treated with various topical or oral medications. These include low dose anti-depressants and anti-seizure medications which primarily manage the pain and may resolve this condition completely.  


The diagnosis of atypical odontalgia is established once all other causes of pain associated with the tooth or teeth have been excluded. Once the diagnosis has been established, treatment may commence. 


To consult an Oral Medicine Specialist regarding your atypical odontalgia, ask your doctor or dentist to refer you to TeleOralMedicine. 

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