Trigeminal neuralgia: a primer for dental practitioners.

OBJECTIVE

Trigeminal neuralgia (TN) is a severe neuropathic facial pain disorder that is frequently misdiagnosed in dental settings, leading to delays in appropriate management and unnecessary irreversible dental procedures. This narrative review aims to synthesize current knowledge on the pathophysiology, diagnostic challenges, and management of TN, with particular emphasis on issues relevant to dental practitioners involved in the differential diagnosis of orofacial pain.

DATA SOURCES: A comprehensive literature search was conducted using the PubMed database, covering studies published between January 2000 and March 2025. Eligible sources comprised controlled clinical trials, systematic reviews, meta-analyses, and selected case reports addressing diagnostic approaches and therapeutic strategies for TN. Findings were synthesized thematically to highlight clinical relevance, emerging therapies, and persisting gaps in care.

CONCLUSION

TN remains a complex disorder with a substantial impact on quality of life. Accurate diagnosis relies on careful clinical history, recognition of characteristic pain features, and exclusion of odontogenic sources of pain, often requiring iterative assessment over time. Pharmacological therapies, including carbamazepine and oxcarbazepine, remain first-line treatments, while surgical interventions-particularly microvascular decompression-offer durable relief in refractory cases. Dental professionals play a critical gatekeeping role in early recognition, exclusion of dental pathology, and timely referral to medical specialists. Optimal management of TN requires an interdisciplinary approach integrating neurology, neurosurgery, dental specialties, and psychosocial care to minimize misdiagnosis, avoid unnecessary dental interventions, and improve patient outcomes.