Oral dysesthesia

Oral dysesthesia – What is it?

Oral dysesthesia is a challenging condition for both doctors and patients. It is a painful or unpleasant abnormal sensation that is classified into 2 categories of spontaneous or evoked. The pain is what differentiates this condition from paresthesia.

Oral dysesthesia Etiology and Symptoms

The symptoms or oral dysesthesia can vary greatly from patient to patient. The symptoms can consist of a large number of things.

• Feelings of a foreign body
• Exudation
• Squeezing or pulling
• Movement
• Misalignment
• Pain
• Spontaneous thermal sensation or taste
• Feelings of slickness
• Excessive saliva or bubbles
• Dryness

This is likely a combination of neurological and psychological causes with a combination of neurosensory hyper-awareness and psychological effect. The spontaneous types occur for no apparent reason. The evoked types occur after some sort of peripheral nerve trauma. This can be almost any dental procedure, systemic illness, medication side effect, or exposure to chemicals.

The most common type or oral dysesthesia is phantom bite syndrome. Numb chin syndrome is similar to oral dysesthesia but is not under this umbrella.

Oral dysesthesia treatment

A diagnosis of either peripheral or CNS is made by injection of local anesthetic. The treatment consists of behavioral and pharmacological treatments. Cognitive behavioral therapy of coping or distraction skills. Medication we use is neuroleptics or low does antidepressants. Local medical treatments may also be effective. Treatment needs to be with an oral facial pain expert typically found in University settings. The University of Illinois has an orofacial pain clinic and that is were I send any patients that call our office looking for care. The article by Spencer is excellent.

Many patients with this condition end up getting at least some dental treatment that was likely never needed. Unfortunately, this is almost impossible to avoid due to the wide range of symptoms.

Other difficult conditions in dentistry that may be similar to oral dysesthesia.

This is the 7th in a series of 8 posts about orofacial pain with difficult to diagnosis or unusual origin.

1. Cracked tooth syndrome
2. Trigeminal neuralgia
3. Atypical odontalgia     JADA article Marbach Feb 96 JADA      Great lit review
4. Neuralgia-inducing cavitational osteonecrosis or NICO
5. Referred pain
6. Myofascial pain 
7. Burning Mouth Syndrome 
8. Oral dysesthesia

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