Trigeminal Neuralgia at the Faculty of Dentistry, Chulalongkorn University

Objective: Orofacial pain is a complicated oral health problem that results in a low quality of life for the patients and is discouraging for clinicians. The development of pain in orofacial locations stems from a variety of disorders. While dental pain and temporomandibular disorders are the leading causes of orofacial pain, neuropathic pain disorders, primary headache disorders or disorders of associated structures are also quite common. The most common neuropathic pain condition in the orofacial area is trigeminal neuralgia. Methods: This study retrospectively examined 149 trigeminal neuralgia patients at the Department of Oral Medicine, Faculty of Dentistry, Chulalongkorn University for the period of 20 years. Results: The patients’ age range was 20-85 years old. The ratio of females to males was two to one. The pain occurred mainly on the right side of the face (65%). The most common trigger zone was located at the lower right posterior teeth (16%). One third of the patients had dental treatments performed in the area of chief complaint prior to their visits to the school. The dental treatments included extraction and root canal treatment. Carbamazepine was mostly used for this disorder. The lowest dose that effectively controlled the pain was 200 mg per day. The side effects of the drug were vertigo, nausea, vomiting and decreased white blood cell counts. Conclusion: Carbamazepine was the drug of choice for trigeminal neuralgia.