Atypical Odontalgia, often called atypical facial pain, phantom tooth pain or neuropathic tooth pain can be a nightmare for both patients and dentists.
It is often considered to be a psychiatric problem due to somatization disorder or an idiopathic disorder but neither of these constitute an actual diagnosis.
Atypical Trigeminal Neuralgia is the diagnosis sometimes given but that is also a meaningless diagnosis.
What we know is that the patient experiences pain that follows all or part of the trigeminal nerve. There is no cause and effect as is normally seen with the somatosensory nervous system.
Many believe that these are autonomic nervous system issues and can relate to an imbalance between the sympathetic and parasympathetic divisions of the autonomics.
Even though there may not be a specific diagnosis with a specific cause and effect found it can be treated with a Sphenopalatine Ganglion Block which will often temper or eliminate the symptoms very rapidly.
The Sphenopalatine Ganglion is also known as the Pterygopalatine Ganglion, the Nasal Ganglion, Sluder’s Ganglion or Meckel’s Ganglion. Whatever name is give, it is the largest parasympathetic ganglion of the head and sympathetic fibers from the superior cervical ganglion pass thru it and both sympathetic and parasympathetic divisions run along with somatosensory fibers throughout the trigeminal nerve distribution.
Blockage of the Ganglion can often eliminate the pain. Pain is perceived in the limbic system or emotional center of the brain. Pain is essentially an emotional response to nociception.
SPG Blocks have been used for over 100 years and were originally described by Sluder in 1908. They were also the topic of the book “Miracles on Park Avenue” the story of Milton Reder a Ner York ENT who trerated a wide variety of disorders only utilizing Sphenopalatine Ganglion Block.
The blocks are known to be very effective for Cluster headaches, migraines, Sinus Headaches, Trigeminal Neuralgia, Postherpetic neuralgia and many other disorders including Atypical Facial Pain and Atypical Odontalgia as well as many cases of burning mouth syndrome.
There are numerous patient testimonials on Reddit at https://www.reddit.com/r/SPGBlocks/
These blocks can be given by multiple injection techniques including intraoral route, extra-oral route and trans-nasal. There are several devices available commercially to do nasal blocks including the Sphenocath, the Allevio and the TX360 (used in MiRX protocol)
In my experience the best method is utilizing a cotton-tipped nasal catheter that makes self administration of Sphenopalatine Ganglion Blocks extremely simple. More important though is that self administration of the block rmpowers patients and daves countless trips to physician offices and ER departments.