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Occlusal Dysesthesia: Identifying Knowledge Gaps to Advance Clinical Care.
Sara A Esmat1,2, Helen He3, Iacopo Cioffi1,2
1Centre for Multimodal Sensorimotor and Pain Research, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada.
Occlusal dysesthesia (OD) is poorly understood, often misdiagnosed. Research suggests it involves altered central processing, not just teeth issues, highlighting the need for better diagnosis and management strategies.
Area of Science:
- Dental Research
- Neurology
- Psychology
Background:
- Occlusal dysesthesia (OD) presents as persistent discomfort without clear dental causes.
- This condition is poorly understood, leading to frequent misdiagnosis and inconsistent treatment.
- Despite clinical recognition, the underlying mechanisms of OD remain elusive.
Purpose of the Study:
- To comprehensively review the literature on occlusal dysesthesia.
- Identify existing knowledge gaps in its conceptualization and mechanisms.
- Propose research priorities for improved understanding and clinical care.
Main Methods:
- A scoping review adhering to Joanna Briggs Institute guidelines.
- Searched seven databases for English-language publications from 1976 to 2026.
- Included diverse sources like clinical studies, case reports, and reviews; two reviewers screened all records.
Main Results:
- Forty-six articles were included, predominantly non-empirical reports, with most clinical studies from Japan.
- Psychophysical tests showed no altered occlusal discrimination, but psychological distress and depression were common.
- Limited neuroimaging indicated altered central processing, especially in prefrontal areas; no validated diagnostic criteria or management strategies exist.
Conclusions:
- OD is likely a heterogeneous condition involving central processing and perception alterations, not solely occlusal abnormalities.
- Urgent need for multidisciplinary research integrating psychophysics, psychological assessment, and neuroimaging.
- Future research should inform evidence-based diagnosis and management for occlusal dysesthesia.

