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Trigeminal neuralgia: The pain in your jaw might not be your teeth


January 30, 2019

If you were feeling pain along your jaw, your first thought might be that you need to see your dentist, who may think you have a dental abscess and could even perform a root canal. When the pain persists, eventually you may realize the problem is not your teeth after all. This could go on for years before you are finally diagnosed with a nerve disorder called trigeminal neuralgia. For some, this story sounds familiar.

The National Institute of Neurological Disorders and Stroke estimates that 150,000 people are diagnosed with trigeminal neuralgia every year. While the disorder can occur at any age, it is most common in people over the age of 50 and more prevalent in women than in men.

Often, trigeminal neuralgia causes a jabbing or shooting pain in the jaw that might feel like an electric shock. The condition affects the trigeminal nerve, which is how the brain receives sensory information from your face. Contact between the nerve and a normal blood vessel, such as a vein or artery, will lead to a disruption in the signal to the brain. This malfunction triggers a sharp, electric, shock-like pain in the jaw and cheek areas.

What causes it

Conditions leading to trigeminal neuralgia can occur as a result of aging, multiple sclerosis, or other problems that affect the sheath covering certain nerves. In some instances, it can be the result of a tumor pressing on the nerve and short-circuiting its function.

“It is a very painful condition that usually affects one side of the face, typically the cheek or jaw” Aqueel Pabaney, MD, neurosurgeon with Kettering Health Network, explains. “It is caused when one of the blood vessels at the base of the brain come in close contact with the nerve that supplies sensation to the face.”

Attacks of pain can be triggered by just touching the face, and they last from just a moment to several minutes. Those who suffer from the disorder might experience a jolt of severe pain from even the mildest touch, such as applying makeup or brushing their teeth.

How it’s diagnosed

Some people live with the condition for many years before seeking any kind of treatment. If you experience prolonged or regularly recurring bouts of facial pain that go unrelieved by over-the-counter medications, that is a sure sign that it is time to see a doctor.

While it is helpful for a patient to be seen and evaluated by a dentist to rule out a dental issue, the problem can be readily differentiated from dental pain. Typically, the pain is sharp and brought on by talking, chewing, touching or washing the face, air hitting the face, and so on. A brain lesion or other neurological abnormality might also result in trigeminal neuralgia, as might surgical injuries, facial or jaw trauma, and even stroke.

How it’s treated

Once diagnosed, there are a number of treatment options including medications, surgery, and radiation.

While surgery may sound intimidating, it is highly effective for treating trigeminal neuralgia. One of the most common procedures is a surgical treatment called microvascular decompression (MVD).

“This procedure takes about two hours and involves making a small hole in the skull behind the ear to access the trigeminal nerve,” said Dr. Pabaney. “We then move away the offending blood vessel that’s pressing on the nerve, and the nerve is padded to avoid future contact.”

One of the most advanced forms of treatment for trigeminal neuralgia uses Gamma Knife Perfexion ™ radiosurgery technology. Radiosurgery delivers highly focused beams of radiation to an abnormality in the brain without a knife or surgical incision. With such a precise and accurate delivery of the radiation, only the abnormality is treated without disturbing the surrounding healthy tissue.

Radiosurgery with Gamma Knife has been offered by Kettering Medical Center since 1999 and has provided treatment for more than 500,000 patients. These painless, incision-free procedures are performed with the highest level of computerized planning and help to reduce risks that come with traditional surgical procedures.

If you’ve been experiencing unexplained facial or jaw pain, it might be time to have a specialist evaluate the problem. For more information or to make an appointment, contact Kettering Health Network Brain & Spine at 1-844-211-5482.