Clinical pathways in occlusal dysesthesia: A scoping review of recognition failure, repeated dental intervention, and iatrogenic risk.

OBJECTIVES

To synthesize the clinical pathway of occlusal dysesthesia (OD), emphasizing recognition failure, repeated dental intervention, provider switching, and iatrogenic risk.

MATERIALS AND

METHODS

Five databases, trial registries, and supplementary searches were completed through 1 August 2026. PRISMA-ScR narrative synthesis used study-ID denominators and assessed cohort overlap.

RESULTS

Thirty-four records were included. Patient-level sources reported 752 participants; cohort overlap precluded deduplication. Among applicable records, delay was reported in 15/18, provider switching in 14/18, occlusal adjustment in 15/16, prosthetic treatment in 14/16, orthodontic treatment in 8/16, and persistence or worsening after dental intervention in 16/16. These fractions are not prevalence estimates. Twenty-three of 32 records (71.9%) were CEBM level 4-5; no eligible or ongoing randomized trial was identified.

CONCLUSIONS

Results are consistent with a proposed escalation pathway but establish neither frequency nor causality. After structural assessment, early recognition, avoiding irreversible occlusal treatment, and coordinated biopsychosocial care may reduce iatrogenic burden.