Occlusal Dysesthesia (Phantom Bite Syndrome): A Scoping Review

Area of Science:

• Dentistry
• Neurology
• Psychiatry

Background:

• Occlusal dysesthesia (OD), also known as phantom bite syndrome, is a condition marked by a subjective feeling of an incorrect bite without objective dental issues.
• It primarily affects middle-aged women and can persist for years, suggesting a complex underlying cause beyond simple occlusal pathology.

Purpose of the Study:

• To conduct a scoping review synthesizing current evidence on the epidemiology, etiology, clinical presentation, diagnosis, and management of OD.
• To identify gaps in the literature and highlight the need for high-quality research.

Main Methods:

• Systematic literature search across multiple databases (PubMed, Google Scholar, Scopus, Web of Science, ScienceDirect, Cochrane Library).
• Keywords included "phantom bite," "occlusal dysesthesia," "occlusal hyperawareness," "occlusal hypervigilance," "uncomfortable occlusion," and "oral cenestopathy."
• Screening and quality assessment using PRISMA (2020) and Oxford CEBM levels of evidence.

Main Results:

• Twenty studies were included, predominantly featuring middle-aged women with long-standing symptoms.
• OD is likely caused by central sensory or signal processing disorders, often co-occurring with psychiatric comorbidities.
• Conservative, multidisciplinary management (education, CBT, pharmacotherapy) is recommended; irreversible dental treatments are contraindicated.

Conclusions:

• Occlusal dysesthesia is a complex biopsychosocial condition necessitating multidisciplinary care.
• Current evidence is of low quality, mainly from case reports and series.
• High-quality controlled trials are crucial for establishing evidence-based diagnostic criteria and treatment protocols.