Ms. Mao is 56 years old. Ten years ago, she began experiencing intermittent pain in her left teeth. Her left cheek felt like it had been cut with a knife, but she always thought it was just toothache. Gradually, most of her left teeth were extracted, but the pain remained severe. Recently, she learned that it wasn't toothache, but trigeminal neuralgia.
Patients like Ms. Mao are not uncommon. She often mistakenly believes it's just a simple toothache. After tooth extraction, the pain disappears. After multiple medical examinations, she finally discovers the culprit is trigeminal neuralgia.
How to distinguish between trigeminal neuralgia and toothache?
Toothache: As the saying goes, "A toothache isn't a disease, but it can be excruciating." Toothache is generally a persistent, localized, aching sensation. It's mainly caused by inflammation or ulceration of the tissues surrounding the tooth or the gums. It can also be caused by disease in the tooth root, resulting in persistent pain that worsens with hot or cold stimuli. Treatment often involves taking anti-inflammatory medications such as metronidazole, which can relieve the pain. Toothache is usually completely relieved after tooth extraction. If the pain persists, trigeminal neuralgia should be considered.
Trigeminal neuralgia is a cranial nerve disorder that commonly affects middle-aged and elderly people. It typically manifests as recurrent, paroxysmal, severe pain in the distribution area of the trigeminal nerve on one side of the face. The pain is described as lightning-like, knife-like, or burning, and is extremely unbearable. Due to trigger points, patients experience pain when speaking, washing their face, brushing their teeth, or even walking. The pain lasts for seconds or minutes. The pain is periodic, with intervals similar to those in healthy individuals.
In the early stages of trigeminal neuralgia treatment, oral carbamazepine or oxcarbazepine can be used to effectively relieve pain. If the medication is ineffective or has severe side effects, surgical treatment may be considered. If the trigeminal neuralgia is clearly caused by vascular compression, microvascular decompression can be performed to completely eliminate the pain. If it is found to be caused by a tumor or other lesions, appropriate surgical treatment may also be considered.