Each year doctors treat about 150,000 new cases of severe facial pain. If you're one of those people, you don't have to suffer—there are ways to gain relief from these painful episodes.

Those recurring episodes are known as trigeminal neuralgia (TN). As the name implies, the source of the pain are the trigeminal nerves, which originate in the brain stem and extend on either side of the face. Each is divided into three branches (hence the "tri" in trigeminal) that serve the upper, middle and lower parts of the face and jaw.

TN can involve one or more of these branches, resulting in mild to severe pain that can last for several seconds. Jaw movements like chewing or speaking can trigger an episode, as well as a light touch to the face.

There are various proposed causes for TN, including links with inflammatory disorders like multiple sclerosis, which damages the insulating sheathing around nerve cells. The most common cause, though, appears to be a blood vessel pressing against the nerve. The compression causes hypersensitivity in that area of the nerve so that it transmits pain at the slightest sensation.

Other conditions like jaw joint pain disorders (TMD) or a dental abscess can cause similar pain symptoms, so it's important to get an accurate diagnosis. If your doctor does identify your condition as TN, you may then need a comprehensive approach to treatment involving a team of care providers, including your dentist.

For the most part, TN can be managed, beginning with the most conservative approach to gain relief, often with medications to block the nerve's pain signals to the brain or decrease abnormal nerve firings. If that proves insufficient, though, more intensive treatments are available.

One possible treatment for an impinging blood vessel is a microsurgical procedure to expose the affected nerve and relocate the vessel. While this can be effective, the surgery does carry some risk of facial numbness or decreased hearing. If the risks are too high for conventional surgery, an alternative procedure uses a precise beam of high-dose radiation to relieve the pressure from the vessel.

The most important thing to know about TN, though, is that it is possible to control it and relieve future pain episodes. If you're experiencing these symptoms, see your dentist or doctor for an exam and accurate diagnosis.

If you would like more information on trigeminal neuralgia, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Trigeminal Neuralgia: A Nerve Disorder that Causes Facial Pain.”

Life would be harrowing if we had no ability to feel pain. Although experiencing it is unpleasant, pain's purpose is to alert us to something wrong in our body. Without pain diseases and other problems could worsen to the point of life-threatening.

But pain without a purpose — the nerves simply misfiring — can make life miserable. This can happen with the trigeminal nerves that exit the brain stem and end on each side of the face. Each nerve has three branches that serve the upper, middle and lower parts of the face and jaw.

When they don't work properly, trigeminal nerves can give rise to a disorder known as trigeminal neuralgia. Beginning often as an occasional twinge, they may escalate to several seconds of mild to excruciating pain occurring over weeks, months or even years. An episode may erupt from chewing, speaking or even lightly touching of the face.

We see this condition most often in people over fifty, particularly women. We don't know the exact cause, but there's strong suspicion that the nerve's protective sheath has been damaged, similar to what occurs with multiple sclerosis or other inflammatory conditions. Another possibility is a blood vessel putting pressure on the nerve and disrupting its normal operation. Such an impinged nerve might transmit pain signals at the slightest stimulation and then fail to “switch off” when the stimulation stops.

Although we can't cure trigeminal neuralgia, we can help you manage it and reduce discomfort during episodes. We'll first try conservative, less-invasive techniques, like signal-blocking medications or drugs that reduce abnormal firing.

If these aren't effective, we may then recommend a surgical solution. One such procedure is known as percutaneous treatment in which we insert a thin needle to selectively damage nerve fibers to prevent their firing. If we've determined an artery or vein has compressed the nerve, we might surgically relocate the vessel. These techniques can be quite effective but they do have possible side effects like numbness or hearing loss.

If you've experienced facial pain, don't continue to suffer. Visit us for a complete examination and learn about your options for pain relief. More than likely, there's a way to reduce your pain and improve your quality of life.

If you would like more information on facial pain, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Trigeminal Neuralgia.”