• Anna Miura, Trang T H Tu, Yukiko Shinohara, Lou Mikuzuki, Kaoru Kawasaki, Shiori Sugawara, Takayuki Suga, Takeshi Watanabe, Motoko Watanabe, Yojiro Umezaki, Tatsuya Yoshikawa, Haruhiko Motomura, Miho Takenoshita, Hidefumi Maeda, and Akira Toyofuku.
• Department of Psychosomatic Dentistry, Graduate school of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
• J Psychosom Res. 2018 Jan 1; 104: 35-40.

ObjectiveAtypical Odontalgia (AO) is a condition characterized by tooth pain with no apparent cause. Although psychiatric comorbidity seems to be very common, it has rarely been studied. To clarify the influence of psychiatric comorbidity on the clinical features in patients with AO, we retrospectively evaluated their examination records.MethodsClinical features and psychiatric diagnoses of 383 patients with AO were investigated by reviewing patients' medical records and referral letters. Psychiatric diagnoses were categorized according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). We also analyzed visual analogue scale (VAS), self-rating depression scale (SDS), and the short-form McGill pain questionnaire (SF-MPQ) scores.ResultsOf the 383 patients with AO, 177 (46.2%) had comorbid psychiatric disorders. The most common were depressive disorders (15.4%) and anxiety disorders (10.1%). Serious psychotic disorders such as bipolar disorder (3.0%) and schizophrenia (1.8%) were rare. Dental trigger of AO was reported in 217 (56.7%) patients. There were no significant correlations between psychiatric comorbidities and most of the demographic features. Higher VAS and SDS scores, higher frequency of sleep disturbance, and higher ratings of "Fearful" and "Punishing-cruel" descriptors of the SF-MPQ were found in patients with psychiatric comorbidity.ConclusionsAbout half of AO patients had comorbid psychiatric disorders. Dental procedures are not necessarily causative factors of AO. In AO patients with comorbid psychiatric disorders, pain might have a larger emotional component than a sensory one. VAS, SDS, and SF-MPQ scores might aid in the noticing of underlying comorbid psychiatric disorders in AO patients.Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

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