Trigeminal neuralgia is a very painful condition where pain radiates into the face and jaw. The trigeminal nerve carries pain, feeling and sensation from the brain to the skin of the face. In the case of trigeminal neuralgia, most medical professionals cannot find a cause for the pain to have started.
The difficulty in diagnosis and the problems of too much treatment or inappropropriate treatment was recently discussed by doctors in Germany.
- Trigeminal neuralgia is characterized by repetitive pain commonly triggered by chewing and manipulation of the gums.
- Due to these symptoms, patients are likely to consult their local dentist when symptoms first develop and may receive further dental evaluation and treatment before they are referred to a neurologist or neurosurgeon.
- Forty-one patients (82% of the study group) initially consulted their dentist; of these, 27 patients received invasive dental treatment for the pain syndrome, including extractions, root canal treatments, and implants.
- A high percentage of patients that are surgically treated for trigeminal neuralgia consult their dentist first and receive possibly unjustified dental treatment. Differential diagnoses include odontogenic pain syndromes as well as atypical orofacial pain.
- This study acknowledges difficulties in correctly diagnosing trigeminal neuralgia, but seems to underestimate the extent.1
The same study looked at the surgical treatment options:
- Eighty-two percutaneous rhizotomies (destroying part of the nerve causing pain) and 33 microvascular decompressions (open brain surgery to relieve pressure on the cranial nerve) were performed in 99 trigeminal neuralgia patients.Two thirds reported being pain-free in follow up.
These are very difficult procedures and invasive procedures to get only 2 out of 3 patients pain-free. One out of three continues on with their pain.