Trigeminal Neuralgia: Important Aspects in Dental Practice

Abstract

Trigeminal neuralgia is the most known and debilitating form of facial neuralgia. It is considered one of the most severe and unbearable pains described by medicine, and it may even lead to suicide. It is characterized by recurrent episodes of intense, paroxysmal facial pain (sudden onset and brief duration), described as throbbing, burning or in the form of electric shock, prick or stab. There is no doubt that the trigeminal neuralgia results from irritation of one or more branches of the fifth cranial nerve, but the etiology and pathophysiological mechanisms are still not fully understood. The main etiological hypothesis for the essential trigeminal neuralgia is the vascular compression on the sensory root of the trigeminal nerve (proximal part). There are basically two kinds of treatment: clinical or drug and surgery. The conservative clinical treatment is the first choice, resorting to the neurosurgery only in cases in which medical therapy is unsuccessful. In this context, it is of utmost importance that the dental surgeon knows how to diagnose and refer the patient for the correct treatment, thus avoiding that he goes through unnecessary dental procedures, which leads to further suffering. The aim of this research was to make a bibliographic review of trigeminal neuralgia presenting signs and symptoms, etiology, pathophysiology and treatment forms, important aspects to dental practice.