Trigeminal Neuralgia: Clinical Case Report and Management of First Contact in Dentistry

Abstract

Introduction: Trigeminal neuralgia is characterized by paroxysmal pain, affecting the fifth cranial nerve with 3 branches with sensory and motor fibers. Its prevalence in the population is low but it is estimated that it affects more women than men. The diagnosis must be clinical, with a detailed clinical history and a precise physical examination. Their initial and follow-up treatments are mostly palliative, with pharmacological treatment as the line of first choice until surgical interventions. Objective: To create knowledge in the dentist about the initial diagnosis, clinical aspects, treatment, and management of a patient with symptoms of trigeminal neuralgia and to recognize the important role played by being the first medical contact with the patient. Case presentation: A 64-year-old male patient attended for emergency reasons referring pain in the upper right hemiarch due to third molar extraction, with a chronic degenerative history of systemic arterial hypertension. Upon intraoral examination, no apparent lesion was observed, not even radiographically. After performing a skull tomography and confirming the diagnosis by a specialist, it was decided to continue with pharmacological treatment. Conclusion: Trigeminal neuralgia is a rare disease and is generally diagnosed as toothache due to its proximity to dental structures, which is why the dentist occasionally performs unnecessary and irreparable treatments. A correct assessment and knowledge of the subject is very important for initial management and to avoid malpractice.