Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatr. Nov 19, 2021; 11(11): 1053-1064
Published online Nov 19, 2021. doi: 10.5498/wjp.v11.i11.1053
Phantom bite syndrome: Revelation from clinically focused review
Trang Thi Huyen Tu, Motoko Watanabe, Gayatri Krishnakumar Nayanar, Yojiro Umezaki, Haruhiko Motomura, Yusuke Sato, Akira Toyofuku
Trang Thi Huyen Tu, Department of Basic Dental Sciences, Faculty of Odonto-Stomatology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh 72714, Viet Nam
Trang Thi Huyen Tu, Motoko Watanabe, Gayatri Krishnakumar Nayanar, Akira Toyofuku, Department of Psychosomatic Dentistry, Tokyo Medical and Dental University, Tokyo 113-8510, Japan
Yojiro Umezaki, Department of General Dentistry, Fukuoka Dental College, Fukuoka 814-0193, Japan
Haruhiko Motomura, Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8510, Japan
Yusuke Sato, Gerodontology and Oral Rehabilitation, Tokyo Medical and Dental University (TMDU), Tokyo 113-8510, Japan
Author contributions: Tu TTH, Watanabe M, Umezaki Y and Toyofuku A were involved in manuscript drafting; Nayanar GK, Motomura H and Sato Y critically revised the manuscript; All authors read and approved the manuscript.
Supported by JSPS KAKENHI Grant, No. 19K10328 (to Professor Toyofuku A).
Conflict-of-interest statement: The authors declare that they have no competing interests.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Trang Thi Huyen Tu, DDS, PhD, Lecturer, Research Fellow, Department of Basic Dental Sciences, Faculty of Odonto-Stomatology, University of Medicine and Pharmacy at Ho Chi Minh City, 652 Nguyen Trai, District 5, Ho Chi Minh 72714, Viet Nam.
Received: May 7, 2021
Peer-review started: May 7, 2021
First decision: June 5, 2021
Revised: June 10, 2021
Accepted: August 30, 2021
Article in press: August 30, 2021
Published online: November 19, 2021

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.