S1 Guideline (extended version)

Background: The diagnosis and management of patients suffering from occlusal dysesthesia (OD) remains a major challenge for dentists and affected patients. Objectives: To present the results of a literature-based expert consensus intended to promote better understanding of OD and to facilitate the identification and management of affected patients. Methods: In 2018, electronic literature searches were carried out in PubMed, Cochrane Library, and Google Scholar as well as in the archives of relevant journals not listed in these databases. This approach was complemented by a careful assessment of the reference lists of the identified relevant articles. The articles were weighted by evidence level, followed by an evaluation of their contents and a discussion. The result represents an expert consensus. Results: Based on the contents of the 77 articles identified in the search, the current knowledge about the clinical characteristics, epidemiology, etiology, diagnostic process, differential diagnosis, and management of OD is summarized. Conclusions: OD exists independently of the occlusion. Instead, it is the result of maladaptive signal processing. The focus should be on patient education, counseling, defocusing, cognitive behavioral therapy, supportive drug therapy, and certain non-specific measures. Irreversible treatment, specifically an exclusively dental treatment approach, must be avoided. Keywords: facial pain, malocclusion, phantom bite syndrome, somatic symptom disorders, temporomandibular disorders