What should I do about trigeminal neuralgia of the teeth?

Written by Li Bao Hua
Dentistry
Updated on September 26, 2024
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Trigeminal neuralgia in the teeth is generally caused by lesions in the areas controlled by the trigeminal nerve, leading to pain. This pain has trigger points, which could be a particular patch of skin or triggered during face washing, producing paroxysmal, electric shock-like pain. It is important to differentiate this from tooth-related nerve pain. Sometimes toothache may resemble symptoms of trigeminal neuralgia. If dental treatment does not relieve the pain, it might be trigeminal neuralgia related to the teeth. Trigeminal neuralgia requires medication, and there are many types of treatments available. If medicinal treatment proves ineffective, surgical treatment or acupuncture may be employed. In severe cases, nerve tissue blockage can be performed to temporarily relieve the pain.

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Written by Gao Yi Shen
Neurosurgery
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Trigeminal neuralgia prodrome

Trigeminal neuralgia does not have very obvious precursors. This is because trigeminal neuralgia often occurs suddenly, especially with the concept of trigger points. That is to say, once the trigger point is activated, it immediately induces pain without any warning signs. Trigger points vary from person to person, usually located primarily on the cheek. Patients who frequently suffer from trigeminal neuralgia often know these areas. Typically, the pain occurs during activities like brushing teeth with cold water or chewing hard foods such as peanuts or walnuts, triggering severe pain instantly. Thus, in the case of trigeminal neuralgia, there are no precursors, only immediate triggers and immediate pain.

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Written by Guo Zhi Fei
Neurosurgery
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Trigeminal neuralgia is divided into several branches.

Trigeminal neuralgia is anatomically divided into three branches: the first branch is the ophthalmic branch, the second branch is the maxillary branch, and the third branch is the mandibular branch. The scope of pain can be used to roughly determine which branch is affected. Generally, pain located in the forehead area is caused by the first branch, the ophthalmic branch. Pain in the area from the tip of the nose to the lips is caused by the second branch, the maxillary branch. Pain from the lips to the angle of the jaw is caused by the third branch, the mandibular branch. Therefore, we can understand which branch is in pain by the distribution area and scope of the trigeminal neuralgia.

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Written by Chen Yu Fei
Neurosurgery
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Which hospital is good for trigeminal neuralgia?

For trigeminal neuralgia, it is generally recommended that patients seek medical advice from a prominent tertiary hospital early in the onset and consult a neurosurgeon to assess their condition. Once diagnosed with trigeminal neuralgia, initial treatment can often start with oral medication, which can relieve pain to a certain extent for most patients. However, medication alone rarely cures the condition completely. Clinically, it is typically recommended that patients undergo microvascular decompression surgery, which has satisfying therapeutic outcomes for most patients, gradually alleviating, or even eliminating, the symptoms of trigeminal neuralgia pain. Therefore, for such patients, early diagnosis and treatment are advised.

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Written by Jiang Fang Shuai
Neurosurgery
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Is trigeminal neuralgia dangerous?

Trigeminal neuralgia manifests in the regions of the face covered by the distributions of the trigeminal nerve, featuring recurrent, severe pain. The onset of the disorder is sudden and it resolves quickly as well. The pain is usually described as cutting, electric shock-like, burning, or tearing; it is a stubborn, difficult-to-treat pain, colloquially known as the "king of pain" and "the foremost pain in the world," which reflects the extreme level of pain associated with trigeminal neuralgia. Trigeminal neuralgia is generally not fatal, but it inflicts significant harm on the human body, making sufferers feel as if death would be preferable. It causes substantial psychological and physical obstacles and can even trigger the onset of some cardiovascular and cerebrovascular diseases, potentially leading to sudden death. Thus, trigeminal neuralgia is considered a rather dangerous disease.

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Written by Shu Zhi Qiang
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How is trigeminal neuralgia diagnosed?

Trigeminal neuralgia is divided into primary and secondary types. Primary trigeminal neuralgia refers to cases where no specific cause is apparent. However, with the advancement of modern medicine, doctors have discovered that there is actually a cause for primary trigeminal neuralgia. It is due to the lack of protective myelin sheath over the initial segment of the trigeminal nerve, which gets irritated by the pulsation of nearby small arteries. In such cases, further investigations like brain MRI and cerebral angiography can usually identify the responsible blood vessel. On the other hand, secondary trigeminal neuralgia occurs along with corresponding tumors and inflammation during the progression of the neuralgia, and MRI can assist in diagnosis.