Welcome to my blog. I am Dr. Farshid Ariz, and if you are reading this, you or a loved one might be dealing with facial pain that just doesn’t seem to go away. In my years practicing as a periodontist here in Northridge and serving the wonderful communities of the San Fernando Valley, I have met many patients who come in clutching their jaw, convinced they have a terrible tooth infection.
Sometimes, they are right. But other times, after I take X-rays and perform a thorough examination, the teeth and gums look healthy, yet the pain remains. This is where we have to look deeper. We have to look at the nerves. Today, I want to share my knowledge about a condition that is often misunderstood but very treatable: Facial Neuralgia.
My goal as your local perio dentist is not just to fix your gums but to ensure your overall quality of life is high. Understanding the source of your pain is the first step toward relief. Let’s dive into what this condition is, why it happens, and how we can manage it together.
What is Facial Neuralgia?
Facial neuralgia is a fancy medical term, but let’s break it down. “Neuralgia” simply means nerve pain. So, when we talk about facial neuralgia, we are talking about pain resulting from a specific nerve in the face that is irritated, damaged, or misfiring. Unlike the dull ache of a cavity or the throbbing of a gum abscess, nerve pain often feels sharp, electric, or sudden.
In my Northridge office, I often explain to patients that our faces are wired like a house. We have complex circuits running from our brain to our jaw, lips, cheeks, and forehead. When one of these wires gets pinched or stripped, it sends a “danger” signal to the brain, which you feel as intense pain. Because these nerves run right alongside your teeth and jawbone, it is very common for people to mistake this nerve issue for a dental problem.
The Main Culprit: Trigeminal Neuralgia
While there are different types of facial pain, the most common form I see discussed in medical circles is trigeminal neuralgia. The trigeminal nerve is the fifth cranial nerve, and it is a big one. It is responsible for carrying sensation from your face to your brain. It has three main branches:
- The Ophthalmic Branch: Covers the eye, forehead, and nose.
- The Maxillary Branch: Covers the upper jaw, teeth, gums, and cheek.
- The Mandibular Branch: Covers the lower jaw, teeth, gums, and lip.
As you can see, two out of those three branches are directly related to your mouth! This is why trigeminal neuralgia is such an important topic for a periodontist like me. If you have pain in the maxillary or mandibular branches, it feels exactly like a toothache. Patients often undergo unnecessary root canals or extractions before realizing the problem wasn’t the tooth—it was the nerve.
Spotting the Symptoms
How do you know if you are dealing with trigeminal neuralgia or a gum issue? In my experience, the symptoms are quite specific. My patients often describe the sensation as a shock, like electricity hitting their face. It can last for a few seconds or a few minutes. It can be triggered by things that shouldn’t hurt at all, such as:
- Lightly touching your face.
- Brushing your teeth.
- Eating or drinking.
- Putting on makeup.
- Even a light breeze hitting your cheek.
Between these attacks, you might feel totally fine, or you might have a dull, constant ache. It is an unpredictable condition, which is what makes it so stressful for those living with it.
Why Does This Happen?
You might be wondering, “Dr. Ariz, why is my nerve acting up?” It is a great question. The most common cause is a blood vessel pressing against the trigeminal nerve as it exits the brainstem. This pressure wears away the protective coating of the nerve (called the myelin sheath). Think of it like an electrical wire where the plastic insulation has rubbed off—the raw wire is exposed, causing sparks.
However, aging, certain medical conditions, and inflammation can also play a role. And this is where my role as a periodontist becomes vital. Chronic inflammation in the body, including severe gum disease (periodontitis), can contribute to systemic health issues. While gum disease doesn’t directly cause neuralgia, keeping your mouth free of infection reduces the overall inflammatory burden on your head and neck area.
Data Point: The Prevalence of Pain
It is helpful to know you are not alone. According to recent neurological statistics:
- Approximately 150,000 people are diagnosed with trigeminal neuralgia every year.
- Women are significantly more likely to develop this condition than men, and it is most common in people over the age of 50.
This demographic data helps us look out for specific risk factors when patients visit us in Northridge.
The Role of a Perio Dentist in Diagnosis
You might think you should go straight to a neurologist, and eventually, you might need to. But often, the dentist is the first line of defense. When you come to see me, I take a “whole picture” approach. I want to brand myself not just as someone who cleans gums, but as a doctor who understands the entire craniofacial system.
Here is my process:
- Rule Out Dental Infection: First, I must be 100% sure the pain isn’t coming from periodontal disease, a cracked tooth, or an abscess. We use high-tech imaging to see below the gum line.
- Check for TMJ Disorders: Sometimes, jaw joint issues (TMJ) can mimic neuralgia. I check your bite and jaw function.
- Listen to the History: This is the most important part. If you tell me the pain is triggered by the wind or feels like a shock, I immediately suspect neuralgia.
If I confirm that your teeth and gums are healthy, I can save you from unnecessary dental procedures. I have seen patients who asked other dentists to pull perfectly healthy teeth because the pain was so bad. My job is to protect your teeth and guide you to the right treatment for the nerve pain.
Visualizing the Pain Triggers
To help you understand how sensitive this condition can be, I have put together a chart showing the most common triggers reported by patients. These are everyday activities that become difficult for neuralgia sufferers.
Common Triggers for Facial Neuralgia Episodes
*Based on aggregated patient reporting data.
Treatment Options and Management
The good news is that we have ways to manage this. While I handle the dental side, managing trigeminal neuralgia often involves a team approach. This is standard for how we operate in the Northridge medical community—referring to and working with the best specialists.
Medication
Unlike standard pain, neuralgia usually does not respond well to regular painkillers like ibuprofen. Instead, doctors often prescribe anticonvulsants. These medications help to calm the nerve down and stop it from firing those “shock” signals. Muscle relaxants can also be helpful.
Dental Management
As your dentist, I play a crucial role in your comfort. If brushing is a trigger, your oral hygiene might suffer, which leads to gum disease. I can prescribe special rinses that keep your mouth clean without the aggressive scrubbing of a toothbrush. We can also schedule cleanings under local anesthesia so that you can get your periodontal maintenance done without fear of pain.
Surgical Options
For severe cases where medication doesn’t work, there are surgical procedures to relieve the pressure on the nerve. These range from non-invasive radiation procedures to microsurgery. It is good to know these options exist if you need them.
Living a Pain-Free Life in Northridge
I believe that living with chronic pain is not something you should just “accept.” It affects your mood, your sleep, and your relationships. In the San Fernando Valley, we have access to excellent resources, and it starts with proper identification.
If you have been suffering from facial pain, I want to encourage you to be proactive. Do not ignore it, and do not assume it is just a cavity. When you come to my office, I promise to listen to you. We will look at your dental health, but we will also look at your nerve health. I pride myself on being a Perio Dentist who sees the person behind the smile.
For more in-depth reading on the neurological aspects of this condition, I recommend this resource from the National Institute of Neurological Disorders and Stroke. It is a high-authority source that backs up much of what we discuss regarding nerve health.
Your Next Steps
If you reside in Northridge, Reseda, Tarzana, or the surrounding areas, and you are unsure about the pain in your face or jaw, please reach out to me. Let’s sit down and figure this out. Whether it is periodontal disease that needs treating or a referral to a nerve specialist for trigeminal neuralgia, I am here to guide you toward health.
Your comfort is my priority. Let’s get you smiling without fear of pain again.