Heather Lawson-Myers - TOOTH TALK TRIGEMINAL NEURALGIA (also known as tic doulourex) is one of the most painful conditions that exists. It affects the face, more specifically the lower lip, lower teeth, under the tongue, upper lip and cheek, nose and above the eyes.
The Trigeminal nerve is the nerve that is responsible for the sensations that we feel in the face. Neuralgia is severe pain, often throbbing or shooting, in the distribution of a nerve. Trigeminal neuralgia can be the most excruciating pain known to man.
The trigeminal nerve is divided into three branches. The first branch supplies feeling to the area above and around the eye; the second branch supplies feeling to the upper jaw area and the third branch serves the lower jaw. Trigeminal neuralgia most commonly involves the second and third branches but it may involve the first branch alone, any two branches or all three.
Trigeminal neuralgia may mimic a toothache, sinusitis or unexplained headaches. Touching a certain part of the face (trigger zone), chewing, washing the face, and brushing the teeth, may trigger the pain, but it may occur spontaneously. It is a unilateral disorder (usually the right side) of facial pain. The pain may be described as lancing, piercing, stabbing burning or feeling like an electric shock. Studies show that the first symptoms commonly occur in persons over 50 years of age and affects women more than men.
The cause of Trigeminal neuralgia is not known. However, some theories are that there is irritation to the nerve due to either changes in the blood vessels in the area of the large trunk of the nerve or the presence of a tumour or lesion causing pressure on the nerve.
Pain medication is usually ineffective in controlling the pain. Tegretol is probably the most effective drug for controlling this pain. Often its effectiveness is not long-lasting and the pain may return after the medication is finished.
Other methods of treatment include injecting a long-lasting anaesthetic at the trunk of the nerve; a surgical procedure that allows for the placement of a pad between the nerve and blood vessels next to it and using a radiofrequency heating current to destroy the nerve.
Although Trigeminal neuralgia is extremely painful, once
diagnosed there are options to treatment. Early, accurate diagnosis is the key to an improved quality of life. A thorough dental examination can determine whether the origin of the pain is from a dental problem or a neurological problem. Living with the pain need not be an option.
Dr. Heather-Dawn Lawson-Myers, President, Jamaica Dental Association (2003/4).
