06/09/2026
How does the patient describe it?
• Sudden electric shock-like pain
• Stabbing or shooting sensation
• Lasts for a few seconds to 2 minutes
• Usually affects only one side of the face
• Repeated attacks with pain-free intervals.
As dentists, not every pain that a patient points to is of dental origin.
One of the most important conditions we should recognize is Trigeminal Neuralgia (TN)—often called one of the most painful conditions known to medicine.
Patients may say:
🗣️ "It feels like someone is giving me an electric shock."
🗣️ "Even touching my face triggers the pain."
🗣️ "Brushing my teeth or talking starts the pain."
These trigger points are a hallmark of trigeminal neuralgia.
What should you do?
✅ 1. Take a detailed history Ask about the nature of pain, duration, frequency, triggers, and previous episodes. A good history often gives the diagnosis.
✅ 2. Perform a thorough dental examination Look for caries, cracked teeth, pulpal pathology, periodontal abscess, sinus involvement, or any obvious dental cause. If everything appears normal, think beyond the teeth.
✅ 3. Avoid unnecessary dental treatment Do not initiate root canal treatment or extract teeth simply because the pain is in the jaw. Many patients with trigeminal neuralgia undergo irreversible dental procedures before the correct diagnosis is made.
✅ 4. Look for red flags If there is facial numbness, weakness, bilateral pain, continuous pain between attacks, or the patient is younger than 40 years, further evaluation is essential.
✅ 5. Refer appropriately Patients suspected of having trigeminal neuralgia should be referred to a neurologist or an oral medicine and radiology specialist for confirmation of diagnosis and further evaluation.
How is it treated?
The first-line treatment is usually carbamazepine or oxcarbazepine, prescribed and monitored by the treating physician.
Some patients may require MRI evaluation to identify vascular compression or other causes. When medications fail, surgical options such as microvascular decompression or other neurosurgical procedures may be considered.
