Trigeminal neuralgia

Trigeminal neuralgia (TN) is a debilitating neuropathic pain condition characterized by brief, recurrent paroxysms of intense, electric shock-like pain, triggered by light stimuli within the distribution of the trigeminal nerve. Although the symptoms are distinctive, TN is frequently misinterpreted as odontogenic pain, leading to inappropriate dental interventions before the correct diagnosis is made. Aim: to identify the first healthcare professional consulted by patients with TN, evaluate the number of unnecessary dental procedures performed, and determine the time elapsed between symptom onset and correct diagnosis among patients referred to a tertiary public university center. Methods: Seventy-eight patients fulfilling clinical criteria for TN were included. Data were collected using a standardized questionnaire administered during consultation. Results: The mean patient age was 66 ± 10.9 years. The maxillary (V2) and/or mandibular (V3) branches were affected in 82% of cases, with dentists being the first professionals consulted. In contrast, when the ophthalmic (V1) or combined V1–V2 branches were involved, patients more frequently sought physicians. This difference was statistically significant (p=0.019). Overall, 52 patients (87%) underwent unnecessary dental treatments, mainly extractions. A positive correlation was observed between diagnostic delay and the number of extractions performed (r=0.309; p=0.040). No significant associations were found between diagnostic timing and age, sex, pain characteristics, or first professional consulted. Nevertheless, patients diagnosed within 12 months were 80% less likely to have undergone dental extractions. Conclusions: These results highlight the persistent underdiagnosis of TN and the urgent need for ongoing education and awareness among dental and primary healthcare professionals.