A case of atypical odontalgia diagnosed after tooth extraction for toothache and alleviated by pharmacotherapy

Abstract

Introduction: Atypical odontalgia is a challenging dental pain condition with no apparent organic causes, often occurring after dental procedures. Here, we report a case of atypical odontalgia following tooth extractions for dental pain, successfully managed with pharmacotherapy.
Case: A 66-year-old woman experienced recurrent pain in the mandibular left molar region despite multiple tooth extractions. Referred to the Oral Medicine Consultation Clinic, Health Sciences University of Hokkaido Hospital, she showed no organic abnormalities but exhibited mild depressive tendencies. Initial treatment with ethyl loflazepate reduced her VAS score from 70 to 20. After a temporary exacerbation, milnacipran hydrochloride was added, resulting in a VAS score improvement to 10. The patient remains stable on both medications.
Discussion: This case highlights that dental interventions may not effectively address psychosomatic disorders like atypical odontalgia. The combination of anxiolytics and SNRIs proved effective, suggesting a promising therapeutic strategy.