The proper and timely diagnosis of Trigeminal Neuralgia is essential; otherwise, the patient might become the victim of undue tooth extractions.
Trigeminal Neuralgia and extractions?
Trigeminal Neuralgia (TN) patients often get the wrong treatment regime and undergo multiple extractions. Why it's challenging to differentiate a case of Trigeminal Neuralgia from toothache? What treatment modalities a dentist should perform to treat a known case of Trigeminal Neuralgia?
A challenge for dentists
Sometimes it becomes a challenge for a dentist to rule out the cause of ache in all lower teeth of one side of the face in Inferior Alveolar Nerve Neuralgia or TN. So the pain and drug history will play a significant role in its proper diagnosis.
Signs and symptoms
Trigeminal Neuralgia is also known as "Tic Douloureux". A prominent diagnostic feature of TN is its electric shock-like pain. The proper and timely diagnosis of TN is essential. Otherwise, the patient might become the victim of undue extractions.
It is prevalent more in female patients than in males. Aged patients (above 50 years) become a victim of TN more often than youngsters.
TN mainly involves the right side of the face and affects the inferior alveolar nerve. TN pain has a rapid onset but lasts for only a few seconds to two minutes. This pain is stimulated easily by touching a trigger point in the distribution area of that affected nerve.
Different stimuli aggravate TN in patients, like shaving or washing that area with cold water or exposure to cold air by drinking cold water or eating some food from that side.
Treatment modalities
Carbamazepine is useful diagnostically as well as therapeutically to relieve the pain. Local anaesthesia injection of an inferior alveolar nerve will break the pain cycle and help detect the specific sub-division of the involved nerve.
The treatment modality includes drug therapy or surgical interventions. Anticonvulsants such as Carbamazepine acts as the 1st line drug for TN. It is commonly available in the market with the brand name 'Integral'. Its dose and frequency will be increased with time. The second line drug is Gabapentin or Pregabalin.
Moreover, the surgical procedures to treat TN include cryotherapy, chemical destruction of the nerve, microvascular decompression and radiofrequency ablation/ rhizotomy.
