A review of persistent idiopathic dentoalveolar pain (formerly PDAP/Atypical odontalgia)

Introduction: Persistent idiopathic dentoalveolar pain (PIDP) is a persistent pain condition isolated to the dentoalveolar region and has previously been known as PDAP/Atypical odontalgia. Presentation: The challenge in diagnosing PIDP means it is often confused for acute dental pain resulting in patients often receiving a number of dental interventions before a diagnosis is made. This highlights the need for practitioners to be aware of the signs of PIDP as early detection can reduce this risk. Aetiology: The pathophysiology behind PIDP is a subject for much debate. Theories suggest that there may be a link to nerve injury. However, this is complicated by suggestions of links to psychological factors and not all patients reporting dental interventions at the outset. Furthermore it is difficult to determine if the pain has continued since before the intervention or resulted after it. Treatment: Current first line treatment for PIDP revolves around the prescription of systemic medications. Whilst these have been proven to have some efficacy they are not universally effective and side effects can reduce compliance. Local treatments have been trailed to improve this, but further research is required and a gold standard has not been set. Conclusion: Persistent idiopathic dentoalveolar pain an uncommon and poorly understood condition making its diagnosis and treatment challenging. Advances in research are required to the aetiology and treatment of the condition as well as an improvement in clinician's awareness of PIDP. This will hopefully reduce the associated burden on quality of life.