Diagnostics and treatment of trigeminal neuralgia Introduction
– Trigeminal neuralgia (TN) is characterized by uni-lateral evoked short-lasting intense facial pain. Concomitant per-sistent background pain is frequently present.
Purpose
– To outline the work-up and treatment regime in TN and to give advice on the approach to facial pain in dental prac-tice.
Results
– Neurovascular contact causing displacement or at-rophy of the trigeminal nerve is important to TN aetiology. TN can also be secondary to a space-occupying lesion or multiple sclerosis. Early high-quality magnetic resonance imaging is man-datory. Patients are advised to see a dentist to exclude an odontogenic cause of pain. . Dentists are advised to refer facial pain patients to a neurologist if history, clinical examination and imag-ing do not clearly point to an odontogenic cause of pain. First-choice treatment is medical. Medically refractory patients are referred to neurosurgery. Regular dentist check-ups are ad-vised as TN patients may avoid tooth brushing of the affected side. Invasive dental treatments are not likely to evoke pain and cannot change the course of TN.
Conclusions
– Nationwide in Denmark, there is a need for struc-tured and uniform treatment of TN to ensure correct early work-up and treatment. Increased knowledge of TN among dentists is likely to lead to early diagnosis.