Article: Volume 46 Number 8 Page 730 - September 2019

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  Dent Update 2019; 46: 730-737

Oral medicine:  Trigeminal Neuralgia

CPD:  CPD  0:48   (closes in 24 days)

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Abstract: Trigeminal neuralgia is one of the most severe facial pains that patients can experience. This unpredictable, episodic pain, mostly unilateral in the distribution of the trigeminal nerve, results in recurrent shooting pain lasting for seconds to minutes. It is light touch provoked and therefore prevents patients from eating and touching their face, and so has a significant impact on quality of life. Patients often consult a dentist because it usually presents like dental pain. Dentists need to avoid irreversible dental treatment. Response to carbamazepine is good but tolerability is poor. Surgical options are available and are generally successful. Patients can gain further information from a patient support group, such as Trigeminal Neuralgia Association UK.

Clinical relevance: Although rare, trigeminal neuralgia patients often present to dentists who therefore need to recognize it as a non-dental cause of pain in order to avoid irreversible dental treatment.

Author notes: Joanna M Zakrzewska, MD, FDS RCS, FFD RCSI, FFP MRCA, FHEA, Professor and Consultant in Facial Pain, Eastman Dental Hospital, 256 Gray’s Inn Road, London WC1X 8LD, Pain Management Centre, National Hospital for Neurology and Neurosurgery, 25 Cleveland Street, London W1T 4AJ and UCLH NHS Foundation Trust, UK, (email: zakrzewska@ucl.ac.uk).

Objective: To understand the importance of recognizing trigeminal neuralgia so that irreversible dental treatment is avoided. Enhanced CPD DO C