Trigeminal Neuralgia or Dental Pain: How to Distinguish One from Another?

Most people experience dental pain more than once in their lives. If a person feels pain in the face, especially if it’s the jaw or cheek, he or she decides it’s the dentist whom it is best to visit first.

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Yet in some cases (though these are quite rare, compared to cases of tooth pain!) the source of pain is different: trigeminal neuralgia may make you feel as if the problem is of dental nature, but it’s the nerve itself that causes such severe pain. Let’s take a closer look at what trigeminal neuralgia is and what difference there is between the pain caused by trigeminal neuralgia and dental issues.

What Is Trigeminal Neuralgia?

This condition is a chronic one and caused by compression, damage or irritation of the trigeminal nerve. This nerve is located in the head and has several branches which reach such areas as jaw, cheek, lip, forehead, etc. – actually, the nerve, if damaged or irritated, is capable of making you feel pain in almost any part of your face.

In most cases, the pain is unilateral. Sometimes it can be felt on both sides. The feelings may also vary from abrupt yet intense pain (described as stabbing or shooting like electric shocks) to burning and aching (the latter is experienced in case of the so-called atypical trigeminal neuralgia).

The most common reason is blood vessels compressing the nerve. Patients who suffer from the condition visit their dentists, and if there is no obvious pathology, some doctors decide to extract the tooth that is in the pain epicenter: it is a poor decision, because if it’s the trigeminal neuralgia that causes the pain, such a person will lose another tooth without relieving the pain. To avoid unnecessary root canal filling or tooth extraction, it is recommended to consult your GP, if the dentist fails to find the cause of pain.

To diagnose trigeminal neuralgia, you will have to use a dental X-ray first in order to make sure no tooth is cracked, and no infection or inflammation is there. Should your teeth and gums be found perfect, the next step is to visit your GP.

In What Way Does Trigeminal Neuralgia Differ From Dental Pain?

There are no special ways to diagnose trigeminal neuralgia, and your GP will have to base the diagnosis on the description of pain you provide and other symptoms. Still, a GP can use MRI scans to find out whether there is a blood vessel which compresses the nerve or some other thing in your head that irritates the trigeminal nerve.

Though dental pain and the pain caused by TN have quite a lot in common, there are differences which make diagnosing the condition easier.

  • Dental pain is triggered when you touch the tooth itself or the area around it. For example, when you apply cold (by eating ice-cream or drinking cold water) or brush your teeth. On the contrary, TN manifests itself in pain that appears upon touching the skin of your face. Even wind and shaving can cause pain attacks. In the overwhelming majority of cases, dental pain is not triggered by merely touching the skin, whereas TN is.
  • Whether Carbamazepine can help relieve your pain can also help you differentiate between the two: this medicine can help alleviate TN pain within an hour, while it has no effect if it is the dental pain you have. Another medicine of this kind is Oxcarbazepine.
  • The type of pain may also differ. TN is characterized by bursts of severe pain which do not last long (unless you have been suffering from the condition for a long time). Dental pain often lasts much longer, especially if it’s the canals that need treatment.
  • Since the trigeminal nerve can reach almost all parts of the face, TN pain can be felt in the forehead, cheeks, jaws, gums, teeth, eyes, and lips. Dental pain is mostly limited to teeth and gums.

References:

Trigeminal Neuralgia – NHS Choices

Trigeminal neuralgia: Symptoms, causes, and treatment By Christian Nordqvist – MedicalNewsToday

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