Trigeminal Neuralgia, also known as Tic Douloureux, is a chronic nerve pain condition affecting the trigeminal nerve, which supplies sensation to the face, teeth, gums, and jaws.
It is characterised by sudden episodes of severe, electric shock-like facial pain and is often considered one of the most painful conditions experienced by humans.
Who Gets Trigeminal Neuralgia?
Most cases are idiopathic, meaning no specific cause is identified, although compression of the nerve by a blood vessel is often suspected.
Trigeminal Neuralgia is:
- More common in older adults
- More common in females
- Usually affects only one side of the face (unilateral)
In younger patients, it can occasionally be associated with underlying neurological conditions such as multiple sclerosis (MS), which should be considered during assessment.
Common Triggers
Pain attacks can be triggered by very light stimulation, including:
- Touching the face
- Washing the face
- Shaving
- Applying makeup
- Brushing teeth
- Eating or chewing
- Smiling
- Talking
- A light breeze or cold air
Even seemingly harmless daily activities can provoke an episode.
Clinical Findings
Typical features include:
- Sudden, severe facial pain
- Sharp, stabbing, shooting, or lancinating pain
- Electric shock-like sensations
- Pain lasting from a few seconds to a few minutes
- Repeated attacks occurring in clusters
- Pain-free intervals between episodes
- Usually affects one side of the face
- Most commonly involves the maxillary (V2) and mandibular (V3) branches of the trigeminal nerve
Because the pain can be felt in the teeth and jaws, many patients initially believe they have a dental problem.
A key finding is that clinical examination, dental tests, and X-rays are usually normal, despite the severity of symptoms.
Management
Accurate diagnosis is essential because dental treatment will not resolve nerve-related pain.
Management may include:
- Referral to a medical practitioner or neurologist
- MRI imaging to investigate underlying causes
- Medications that stabilise nerve activity
- Surgical procedures in selected cases when medication is ineffective
The Importance of Correct Diagnosis
Not all facial pain originates from the teeth. Trigeminal Neuralgia can closely mimic a toothache, but the treatment is entirely different.
If you are experiencing sudden, severe, electric shock-like facial pain, the team at Dural Dental Practice can help determine whether the source is dental or requires further medical assessment.
