Oral and Maxillofacial Surgery Expert Forum
Extreme pain in tooth possible Trigeminal neuralgia
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Questions in the Oral and Maxillofacial Surgery forum are answered by Dr. Michael H Kirsch and Dr. Mario Tuchman. Topics covered include teeth extractions, wisdom teeth, dental implants, bone grafting, orthognathic surgery, facial bones realignment, facial trauma repair, jaw alignment, anesthesia , jaw cyst or tumor diagnosis, reconstructive jaw surgery, temporomandibular joint syndrome (TMJ) and TMJ surgery.

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Extreme pain in tooth possible Trigeminal neuralgia

I am a 26-year-old male that has severe pain in upper jaw feels as if it is coming from a tooth on right side of my face. The pain will go away for a month or two and come back in a violet attack. The pain is the worst I have ever felt its feels like a shocking pain in my tooth that last for about 10 seconds sometimes followed up by one or two more quick attacks. When I say pain I mean pain it’s the type that will take a grown man to his knees it make you want to vomit its so bad. After the attacks I will usually have a dull intermittent pain that sometimes will even throb but nothing like the attacks for a day or so then it improves and even goes away.

This is where I get strange both attacks have taken place in the shower, I am actually afraid to take a shower. At one time I loved the shower warmth but now it has become the shower of torment.

My teeth have been neglected for years and I maybe have trouble with my wisdom teeth. I have an appointment very soon but I am worried.


When I researched the symptoms I came back with Trigeminal neuralgia does this sound possible?

What are some tell tale ways to separate the two?

And last but not least doses this sound like a problem with the teeth or something more sinister?

Please advise me before the dentist starts removing teeth, root canals and other expensive and patently painful procedures that may not fix the problem.
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Trigeminal neuralgia does explain your symptoms.  Treatment is usually medication which reduces the frequency and intensity of attacks.  

There are other potential causes which can usually be ruled out by a complete history and examination.

Do not start with a general dentist.  You should begin with a Board Certified Oral and Maxillofacial Surgeon.  They are the best type of medical provider to perform the initial evaluation and then "quarterback" any other specialty referrals you may need.  Do no be surprised if an MRI of the brain is ordered.  Some cases of Trigeminal Neuralgia are caused by a blood vessel lying near the Trigeminal Ganglion in the brain.

Information contained within this reply is intended solely for general educational purposes and is not intended nor implied to be a medical diagnosis or treatment recommendation.  This is not a substitute for professional medical advice relative to your specific medical condition or question. Always seek the advice of your own doctor for medical condition. Only your doctor can provide specific diagnoses and therapies.
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I will look for a Maxillofacial Surgeon, thank you I greatly appreciate you taking your time to offer your medical advice.
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Michael H Kirsch, DDSBlank
Dr. Michael H. Kirsch
Caldwell, NJ
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