By: American Association of Oral and Maxillofacial Surgeons – AAOMS
Located in the head and neck, the trigeminal nerve is one of a group of 12 cranial nerves – all with important roles in vision, hearing, and controlling the function of facial muscles. The trigeminal nerve provides feeling to most of the face and mouth, controls the motion of the lower jaw as well as biting and chewing. Problems with the nerve can lead to even the slightest movement causing excruciating pain. Due to its size and placement, it is possible for the trigeminal nerve to be damaged during trauma, from the growth of tumors, or from infections. It also can be injured during surgical procedures such as fracture repairs, orthognathic surgery, oncological surgery, cosmetic surgery, or wisdom teeth extractions.
Patients can work with an oral and maxillofacial surgeon to manage their trigeminal nerve damage through both surgical and non-surgical means.
Trigeminal Nerve Pain
Symptoms of trigeminal nerve pain can vary, and triggers of those symptoms may be inconsistent or vary from person to person. Potential signs of trigeminal nerve pain include:
- Seemingly spontaneous attacks of shooting or stabbing facial pain.
- Facial pain triggered by speaking, chewing, brushing teeth, or simply touching the face.
- Constant aching or burning feeling that can evolve into spasm-like pain.
- Pain in the cheek, jaw, gums, teeth, and lips (occasionally an eye or the forehead).
- Attacks that increase in frequency and intensity over time.
While some patients may experience near-constant pain, others can experience long stretches of pain-free time. Trigeminal nerve pain typically affects one side of the face at a time.
Trigeminal Nerve Diagnosis & Treatments
Due to the broad trigeminal nerve functions, trigeminal nerve pain can have a significant impact on a patient’s quality of life. Significant pain can be caused by everyday behaviors such as chewing or by a light breeze crossing the face. An OMS can often diagnose trigeminal nerve pain based on a patient’s description of the pain, particularly the type and location of pain, as well as what triggers the pain.
From there, an OMS may conduct a neurological examination or have an MRI ordered to determine if there is a specific underlying cause of trigeminal neuralgia or sharp pain that follows the length of the nerve. Trigeminal nerve treatment often begins with medications, including:
- Antispasmodic agents
- Neurotoxin injections (e.g., Botox)
While medication allows some patients to manage their trigeminal nerve pain, others may require surgical treatments, including:
- Microvascular decompression: Relocating or removing blood vessels in contact with the trigeminal nerve can reduce pressure on the nerve.
- Gamma Knife: A focused dose of radiation can damage the trigeminal nerve and reduce or eliminate nerve pain.
- Rhizotomy: Destruction of nerve fibers through thermal lesioning, balloon compression, or glycerol injection.
Learn More from an OMS
Trigeminal nerve pain can significantly impact a patient’s quality of life, and any symptoms should prompt a visit to a doctor and a consult with an OMS.