• Abdur Rehman Dentistry Section, Ayub Medical College, Abbottabad-Pakistan
  • Iram Abbas Dentistry Section, Ayub Medical College, Abbottabad-Pakistan
  • Alamgir Dentistry Section, Ayub Medical College, Abbottabad-Pakistan
  • Shah Muhammad Ghous Dentistry Section, Ayub Medical College, Abbottabad-Pakistan
  • Nofil Ahmad Frontier Medical and Dental College, Abbottabad-Pakisttan
  • Ans Ahmad Postgraduate student, UCLA, Los Angeles-USA


Background: Trigeminal neuralgia is a very painful condition which is presented as severe pain corresponding to spastic shock. This is caused by trigeminal nerve’s vascular compression at root entry zone. The pain is induced due to ipsilateral neurovascular conflict. in spite of the condition being known since centuries, it still continues to frustrate the clinician and its pathogenesis remains as enigma to the medical profession. It is very common for these patients to undergo unnecessary dental extraction without any relief in pain. This study was conducted to assess the association between trigeminal neuralgia and unnecessary tooth extraction. Methods: This was a cross-sectional study conducted between January 2017 and July 2019 in the Department of Dentistry of Ayub Teaching Hospital, Abbottabad. A total of fifty-three cases with Trigeminal neuralgia were included. All the patients were evaluated by history, clinical examination and local anaesthetic injection. Results: Fifty-three Trigeminal neuralgia cases were enrolled in this study; out of which 22 cases (41.5%) were males and 31cases (58.5%) were females. Mean age of all the patients was 53.90 years. Twenty-nine patients (54.7%) had their right side involved, while the left side was involved in 23 patients (43.4%). In only one case (1.9%) there was bilateral involvement. Regarding tooth extraction unnecessary extraction were reported by 25 (47.1%) patients before they were diagnosed to have trigeminal neuralgia. The Maxillary first Premolar was the most common tooth extracted. Conclusion: Trigeminal neuralgia is one of the most severe painful condition of the maxillofacial region which can confuse the patient and the Dentist with toothache. Patient should be evaluated in detail to rule out trigeminal Neuralgia before tooth extraction. Keywords: Trigeminal neuralgia; Toothache; Tooth extraction


Hupp JR, Ellis E, Tucker MR. Facial Neuropathology in : Contemporary Oral and Maxillofacial Surgery, Elsevier Medical Publisher, 2019 ; pp 643-51.

Civelek E, Cansever T, Imer M, Hepgul K, Barlas O. Trigeminal neuralgia and treatment options. Agri 2005;17:19-26.

Malik NA. Trigeminal Neuralgia & its management: In: Malik NA. Textbook of Oral & Maxillofacial Surgery: 2nd ed. New Dehli: Jaypee Brothers Medical Publishers (P) Ltd: 2008: 685-97.

Apfelbaum RI. Comparison of long term results of microvascular decompression and percutaneous trigeminal neurolysis for the treatment of trigeminal neuralgia. International Congress series 2002; 1247:629-43.

Cheshire WP. Trigeminal neuralgia: for one nerve a multitude of treatments. Expert Rev Neurother 2007; 11:1565-79.

Petit JH, Herman JM, Nagda S, Dibiase SJ, Chin LS. Radiosurgical treatment of trigeminal neuralgia: evaluating quality of life and treatment outcomes. Int J Radiat Oncol Biol Phys 2003; 56:1147-53.

Bagheri SC, Trigeminal Neuralgia ; In Clinical review of Oral and Maxillofacial Surgery, Elsevier, 2nd Edition, pp 82-88.

Love S, Coakham HB. Trigeminal neuralgia, Pathology and Pathogenesis. Brain 2001; 124:2347-60.

Chen JF, Lee ST. Comparison of percutaneous trigeminal ganglion compression and microvascular decompression for the management of trigeminal neuralgia. Clin Neurology and Neurosurgery 2003;105:203-08.

Toda K. Trigeminal neuralgia-symptoms, diagnosis, classification, and related disorders. Oral Science International 2007; 4:1-9.

Toda k. Operative treatment of trigeminal neuralgia: review of current techniques. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008; 106: 788-805.

Katusic S, Williams DB, Beard CM, et al. Epidemiology and clinical features of idiopathic trigeminal neuralgia and glossopharyngeal neuralgia: similarities and differences, Rochester, Minnesota, 1945-1984. Neuroepidemiology 1991;10:276-81.

Bruyn GW. Glossopharyngeal neuralgia. Cephalalgia 1983;3:143-57.

Casey KF, Jannetta PJ. Role of patient history and physical examination in the diagnosis of trigeminal neuralgia. Neurosurg Focus. 2005; 18(5):E1.

Rana ZA, Malik AM, Rana IZ. Aggrevating and relieving factors in Trigeminal neuralgia; PIMS experience. Ann Pak Inst Med Sci 2005; 1: 32-6.

Sohail A, Saeed M, Qazi SR. Efficacy of peripheral glycerol injection in the management of trigeminal neuralgia. Pakistan Oral & Dental Jr. 2006; 26:93-6.

Ali M, Khan KM, Khanzada KA, Ayub S, Khan H. Significance of the trigger point in the trigeminal neuralgia. J Post Med Inst 2007; 21:183-6.

Urban PP, Forst T, Lenfus M, Koehler J, Connemann BJ, Bayer J. Incidence of sub-clinical trigeminal neuralgia and facial nerve involvement in diabetes mellitus. Electromyogr Clin Neurophysiol 1999; 39:267-72.



Most read articles by the same author(s)

<< < 1 2