Phantom bite syndrome: Revelation from clinically focused review

Abstract

Phantom bite syndrome (PBS), also called occlusal dysesthesia, is characterized by persistent non-verifiable occlusal discrepancies. Such erroneous and unshakable belief of a “wrong bite” might impel patients to visit multiple dental clinics to meet their requirements to their satisfaction. Subsequently, it takes a toll on their quality of life causing, career disruption, financial loss and suicidal thoughts. In general, patients with PBS are quite rare but distinguishable if ever encountered. Since Marbach reported the first two cases in 1976, there have been dozens of published cases regarding this phenomenon, but only a few original studies were conducted. Despite the lack of official classification and guidelines, many authors agreed on the existence of a PBS “consistent pattern” that clinicians should be made aware. Nevertheless, the treatment approach has been solely based on incomplete knowledge of etiology, in which none of the proposed theories are fully explained in all the available cases. In this review, we have discussed the critical role of enhancing dental professionals’ awareness of this phenomenon and suggested a comprehensive approach for PBS, provided by a multidisciplinary team of dentists, psychiatrists and exclusive psychotherapists.

Keywords: Phantom bite syndrome; Occlusal dysesthesia; Clinical manifestation; Pathophysiology; Treatment strategy; Psychopharmacology

Core Tip: Generally, in dentistry, uncomfortable occlusal sensations are a common finding among patients while phantom bite syndrome (which is distinguishable if ever encountered) is quite rare. These patients present with non-verifiable occlusal discrepancies with strict demands for bite correction and remarkable psychological distress. This might lead to serious consequences on patients’ life quality, relationship with family, financial loss, career disruption or even suicidal thoughts. Recent studies have revealed unexplained diversity patterns among phantom bite syndrome’s clinical manifestation and functional brain imaging, which likely represent the available sub-phenotypes of this syndrome. Further research must be focused on elucidating pathophysiological mechanisms to pave the way for efficient treatment strategy.