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.