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Solving the Puzzle of Pain: Headaches, Migraine and Trigeminal Neuralgia

May 29, 2014

Headaches are no fun. Migraines are worse. And while there are many who say that nothing can beat the pain migraines give, there is actually a worst condition, often called the suicide disease - trigeminal neuralgia.

What is Trigeminal Neuralgia?

Trigeminal neuralgia, also known as tic douloureux, is a painful disorder of a nerve  in the face called the trigeminal nerve or fifth cranial nerve. There are two trigeminal nerves, one on each side of the face. These nerves are responsible for detecting touch, pain, temperature and pressure sensations in areas of the face between the jaw and forehead. You can trace its path by placing your palm over one ear and stretching three fingers across your face: your index finger over your eyebrow, your middle finger across your cheek to your nose, and your ring finger on your lower jaw. Migraines occur on this same nerve, but the pain is different: longer lasting but less intense. People who have trigeminal neuralgia usually have episodes of sudden, intense, "stabbing" or "shocklike" facial pain. This pain can occur almost anywhere between the jaw and forehead, including inside the mouth. Because the pain can be so severe and debilitating, trigeminal neuralgia is often called the “suicide disease.”

The cause of trigeminal neuralgia is currently unknown. Thus, no specific treatment has been developed for its cure.

Trigeminal Neuralgia's Pain Cycle

It begins with a few headaches every now and then, increasing in frequency and severity. They gradually increase your conscious stress load during the day and your unconscious stress load during sleep. This stress, in turn, causes you to clench and grind your teeth more during the course of the day and especially during sleep.  As a matter of fact, tests show that people are able to exert far greater forces on these muscles during the unconscious state of sleep than they are able to exert while conscious.

How our Teeth and Bite is Related to Trigeminal Neuralgia

When a part of  the body is repeatedly traumatized like a slipped disc or dislocated knee, the origin (and frequency) of pain is not questioned. Yet the jaw is rarely even looked at seriously, even after a severe accident. The mouth is the only area in the body in which the skeleton protrudes through the skin (gums). The teeth are like rigid vertical support beams with numerous pieces (tooth) that must position or fit properly like the gears of two meshing gear wheels or like pieces of a 3D puzzle. If they don’t fit together precisely, every part of the oral cavity from the teeth, gums, jawbone and even the base of the skull and cheekbones will be forced to function in a position that is strained. This strains the trigeminal nerve on several fronts. Simple actions like speaking, chewing, swallowing and even teeth grinding can overstimulate the trigeminal nerve and cause pain.

This leads to  increased stress which leads to more clenching and grinding, and the pain cycle just continues. Dentists need learn to understand and permanently eliminate the forces traumatizing the largest cranial nerve, the trigeminal.

Let Us Help

Dr. Reese has been involved in the treatment and alleviation of painful joint conditions for many years. Because of his experience and training in the reconstruction of smiles and teeth, the proper function and role of healthy joint function and mobility has allowed him to help many patients suffering from years of ‘muscle tension headaches’, unexplainable head and neck pain, or diagnosed TMJ problems that has not responded to previous treatment.

Splint therapy has been a common starting point, but many patients need final phases of treatment to prevent recurrence or further breakdown of this vital joint. Dr. Reese has alternative treatments such as ETPS, but may still need to work with physical therapists, and chiropractors in addition to using different drug therapies in addition to the use of splints.

Many patients may need orthodontic care, bridgework, or reconstruction of poor occlusion (bite) to permanently retain the results of relief from trigeminal neuralgia pain.

Dr. Reese is a member of the American Academy of Craniofacial Pain and has been practicing dentistry for over 30 years. If you are suffering from head, neck, or jaw pain, please call Dr. Reese’s office at 317-882-0228 and ask for a consultation. We are located just north of Greenwood, Indiana on US 31 in Indianapolis.