Trigeminal Neuralgia & Tooth Pain

Trigeminal neuralgia is a nerve disorder that causes a disruption in the trigeminal nerve in the face that may result in excruciating facial pain and tooth pain. Tooth pain can have other causes and should be evaluated by a dentist.

Tooth Pain

1. According to MedlinePlus, tooth pain may result from an abscessed tooth, tooth decay or an injury to the mouth or jaw.

Trigeminal Neuralgia Symptoms

2. According to the Mayo Clinic, patients with trigeminal neuralgia may experience severe shooting pain in the teeth and face, mild twinges of facial pain or pain on one side of the face. Pain may last for a few seconds and episodes can last for days or weeks at a time.

Trigeminal Neuralgia Triggers

3. Pain from trigeminal neuralgia can be triggered by brushing teeth, eating or drinking. Shaving, stroking the face or putting on makeup can bring on pain from this disorder.

Trigeminal Neuralgia Testing

4. A doctor may perform a physical examination to determine the triggers of facial pain in a patient and he may use a magnetic resonance imaging test to determine the source of pain.

Trigeminal Neuralgia Treatment

5. Physicians may prescribe medications to reduce pain from trigeminal neuralgia attacks such as anticonvulsants or antispasticity agents. Surgery or radiation treatment of the trigeminal nerve may be used to treat severe cases of this disorder.

Types of Trigeminal Neuralgia

Trigeminal neuralgia (TN), also known as tic douloureux, is a rare neurological disorder that affects the trigeminal nerve. While there is no cure for the disorder, there are treatment options ranging from prescription medication to surgery.

Types

1. The trigeminal nerve runs on either side of the face, radiating outward from the side and fanning out from the forehead down to the jaw. To get an idea of what this looks like, place the heel of your hand at your ear and spread your fingers out. Trigeminal neuralgia is, according to the website of the National Institute of Neurological Disorders and Stroke, "a chronic pain condition that causes extreme, sporadic, sudden burning or shock-like face pain. The pain seldom lasts more than a few seconds or a minute or two per episode. The intensity of pain can be physically and mentally incapacitating. TN pain is typically felt on one side of the jaw or cheek. Episodes can last for days, weeks, or months at a time and then disappear for months or years."
   
   There are two types of trigeminal neuralgia: traditional trigeminal neuralgia and bilateral, meaning it occurs on both sides of the face. Bilateral TN is extremely rare.

Effects

2. Trigeminal neuralgia causes intense pain to shoot across the face. This can be triggered by touching certain parts of the face (different for each patient), or it may be a continuous sharp pain. TN may make eating certain foods or brushing your teeth painful.

Treatment

3. There is no cure for trigeminal neuralgia. There are prescription medications that may be used to treat the symptoms, such as antiseizure medications, anticonvulsant medications, or tricyclic antidepressants. According to the website of the National institute of Neurological Disorders and Stroke, "Typical analgesics and opioids are not usually helpful in treating the sharp, recurring pain caused by TN. If medication fails to relieve pain or produces intolerable side effects such as excess fatigue, surgical treatment may be recommended. Several neurosurgical procedures are available. Some are done on an outpatient basis, while others are more complex and require hospitalization. Some patients choose to manage TN using complementary techniques, usually in combination with drug treatment. These techniques include acupuncture, biofeedback, vitamin therapy, nutritional therapy and electrical stimulation of the nerves."
   
   Promising research has been published linking antidepressants and antiepileptic drugs for the treatments of chronic pain. This study, conducted by Drs. Morris Maizels and Bill McCarberg of Kaiser Permanente in California and published in the February 1, 2005, issue of American Family Physician, was the first to consider certain nontricyclic antidepressants, such as Wellbutrin, for disorders like trigeminal neuralgia. The researchers concluded that "the analgesic effect of these drugs is independent of their antidepressant effect."

Prevalence

4. According to the International RadioSurgery Assocation's website, "Approximately 14,000 people develop TN each year in the United States; about 140,000 people have the condition." The exact cause of trigeminal neuralgia is not known.

Misconceptions

5. Trigeminal neuralgia mainly affects patients who are 50 or older. However, it can occur at any age. Physicians who are not used to treating the disorder may overlook it in a younger patient. Furthermore, there is thought to be a link between trigeminal neuralgia patients who are younger than 50 and multiple sclerosis.
   
   Because of the close proximity of trigeminal neuralgia pain and that of sinus or dental pain, many patients suffer multiple root canals before a diagnosis is made. Often, it is a dental surgeon or ear, nose and throat (ENT) doctor who makes the initial referral to a neurologist.

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Facts

What is Trigeminal Neuralgia?
Trigeminal neuralgia, also called tic douloureux, is a condition that affects the trigeminal nerve (the 5th cranial nerve), one of the largest nerves in the head. The trigeminal nerve is responsible for sending impulses of touch, pain, pressure, and temperature to the brain from the face, jaw, gums, forehead, and around the eyes. Trigeminal neuralgia is characterized by a sudden, severe, electric shock-like or stabbing pain typically felt on one side of the jaw or cheek. The disorder is more common in women than in men and rarely affects anyone younger than 50. The attacks of pain, which generally last several seconds and may be repeated one after the other, may be triggered by talking, brushing teeth, touching the face, chewing, or swallowing. The attacks may come and go throughout the day and last for days, weeks, or months at a time, and then disappear for months or years.

Is there any treatment?
Treatment for trigeminal neuralgia typically includes anticonvulsant medications such as carbamazepine or phenytoin. Baclofen, clonazepam, gabapentin, and valproic acid may also be effective and may be used in combination to achieve pain relief. If medication fails to relieve pain, surgical treatment may be recommended


What is the prognosis?
The disorder is characterized by recurrences and remissions, and successive recurrences may incapacitate the patient. Due to the intensity of the pain, even the fear of an impending attack may prevent activity. Trigeminal neuralgia is not fatal.


What research is being done?
Within the NINDS research programs, trigeminal neuralgia is addressed primarily through studies associated with pain research. NINDS vigorously pursues a research program seeking new treatments for pain and nerve damage with the ultimate goal of reversing debilitating conditions such as trigeminal neuralgia. NINDS has notified research investigators that it is seeking grant applications both in basic and clinical pain research.

Suggested Reading

Education: Learning About Headaches and MigraineEssential Information SheetsHeadaches and Migraine 101

Elsewhere on the Web

National Institute of Neurological Disorders and StrokeNational Institutes of HealthHelp for Headaches and Migraine

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Organizations

Prepared by:
Office of Communications and Public Liaison
National Institute of Neurological Disorders and Stroke
National Institutes of Health
Bethesda, MD 20892

NINDS health-related material is provided for information purposes only and does not necessarily represent endorsement by or an official position of the National Institute of Neurological Disorders and Stroke or any other Federal agency. Advice on the treatment or care of an individual patient should be obtained through consultation with a physician who has examined that patient or is familiar with that patient's medical history.
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My Personal Cause - Trigeminal Neuralgia

 
I suffer from a condition called V2 (maxillary) Trigeminal Neuralgia aka (The Suicide Disease). This condition is debilitating, there is nothing you can do to stop it, and there is no cure. It can be controlled intermittently by using medicine combinations but still isnt a guarantee that you wont have pain episodes. It has been dubbed the most painful condition known to the human race, hence the reason it is called The Suicide Disease.
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Facial Pain and TN Facebook Group

Facial Pain Facebook Group

A discussion page on TN (Trigeminal Neuralgia).
I hope the content and support provided there will help others in need of understanding and provide guidlines and options to discuss with their doctor.
Founded by: Belinda Taylor
Click Here to go to Group Homepage ...