Hello, and welcome. I am Dr. Farshid Ariz, DMD. If you live here in the beautiful community of Northridge or our neighboring areas like Porter Ranch, Granada Hills, or Chatsworth, you might know me as a cosmetic dentist who is passionate about creating beautiful smiles. However, my work goes far beyond just aesthetics. I believe that a healthy smile is the foundation of a healthy life, and sometimes, that means playing detective to solve complex pain issues that affect the face and jaw.
Today, I want to talk to you about a condition that is often misunderstood and frequently misdiagnosed: Facial Neuralgia. In my practice, I often see patients who come in convinced they have a severe toothache, only to find out that their teeth are perfectly healthy, but their nerves are telling a different story. Understanding the source of your pain is the first step toward reclaiming your comfort and your smile.
What Exactly is Facial Neuralgia?
To understand facial neuralgia, we first need to understand a little bit about anatomy, but I promise to keep it simple. Your face is filled with a complex network of nerves that help you feel sensations like touch, temperature, and pain. Neuralgia is a medical term that simply means “nerve pain.” So, facial neuralgia is pain resulting from an irritated or damaged nerve in the face.
Unlike the dull ache of a cavity or the soreness of gum disease, nerve pain is often sharp, shooting, and electrical. It can be incredibly intense. Imagine touching a live wire; that is often how my patients describe the sensation. It can happen spontaneously, or it can be triggered by something as simple as brushing your teeth, putting on makeup, or even feeling a light breeze on your face.
As a dentist in Northridge, I screen for this because facial pain is not always dental pain. It is vital to know the difference so we don’t perform unnecessary dental procedures on healthy teeth.
The Main Culprit: Trigeminal Neuralgia
While there are different types of facial nerve pain, the most common form I encounter is trigeminal neuralgia. You have a large nerve in your head called the trigeminal nerve. It is one of the most important nerves for the face because it carries sensation from your face to your brain.
Think of the trigeminal nerve like a large tree trunk that splits into three main branches:
- The Ophthalmic Branch: Controls sensation in your eye, upper eyelid, and forehead.
- The Maxillary Branch: Covers your lower eyelid, cheek, nostril, upper lip, and upper gum.
- The Mandibular Branch: Runs to your lower lip, lower gum, jaw, and some muscles used for chewing.
When this nerve is irritated, usually by a blood vessel pressing against it at the base of the brain, it misfires. This results in trigeminal neuralgia. Because the branches run through the jaw and teeth, it is very easy to mistake this condition for a dental abscess or a cracked tooth.
A Look at the Numbers
It is helpful to know that if you are suffering from this, you are not alone, though the condition is considered somewhat rare. Here is a data point to help put things in perspective:
Data Point 1: According to the National Institute of Neurological Disorders and Stroke, trigeminal neuralgia affects approximately 12 out of every 100,000 people per year. While this might seem small, for those 12 people, the impact on their quality of life is significant.
Symptoms: Is it a Toothache or Neuralgia?
One of the hardest parts of my job is seeing patients who have been in pain for months. They may have visited other offices and had root canals or extractions, yet the pain remains. This is because the problem was never the tooth; it was the nerve.
I want to help you distinguish between the two. Below is a chart I created to help visualize the differences between typical dental pain and neuralgic pain.
Comparison: Dental Pain vs. Neuralgia
| Feature | Typical Dental Pain | Trigeminal Neuralgia |
|---|---|---|
| Type of Pain | Throbbing, aching, dull, or continuous. | Sharp, electric-shock like, stabbing, or burning. |
| Duration | Lasts for hours or is constant until treated. | Brief bursts (seconds to minutes), comes and goes. |
| Triggers | Hot/cold foods, sweets, biting down. | Light touch, wind, shaving, talking, chewing. |
| Sleep | Often wakes you up at night. | Rarely occurs during sleep. |
| Localization | Usually specific to one tooth or area. | Shoots along the path of the nerve branch. |
If you look at the chart, you can see distinct patterns. If you are in the Northridge area and experiencing those “electric shock” sensations, I strongly encourage you to schedule a consultation with me before assuming you need dental surgery.
Causes and Risk Factors
Why does this happen? The most common cause is simply aging. As we get older, blood vessels can lengthen and curve, eventually touching and pulsating against the nerve. This wears away the protective coating of the nerve, called the myelin sheath. Think of it like a plastic coating on an electrical wire wearing down; eventually, the wires spark.
However, as a cosmetic dentist who focuses on total oral health, I also look at structural issues. Sometimes, inflammation from chronic TMJ (Temporomandibular Joint) disorders can mimic or aggravate neuralgic pain. While TMJ is different from trigeminal neuralgia, they often overlap in the symptoms they present.
Data Point 2: The interplay between jaw health and facial pain is substantial. Research indicates that nearly 12% of the U.S. population experiences TMJ disorders at some point, and many of these cases present with referred facial pain that can be confused with neuralgia.
How We Diagnose Facial Pain in Northridge
When you walk into my office, my goal is to make you feel safe and heard. Diagnosis is a process of elimination. Since there is no single blood test for trigeminal neuralgia, we rely on a comprehensive exam.
First, I will perform a thorough dental evaluation. I use high-quality digital imaging to check for cracked teeth, infections, or sinus issues. If your teeth and gums are healthy, but the pain persists along that specific nerve path, we begin to suspect neuralgia.
We also test your response to pain. If the pain is triggered by lightly touching your skin rather than deep pressure on a tooth, that is a major clue. I may refer you to a neurologist for an MRI to see if a blood vessel is indeed pressing on the nerve.
Treatment Options and My Role as Your Dentist
You might be wondering, “Dr. Ariz, if this is a nerve problem, how can a cosmetic dentist help?” That is a great question. While I do not perform brain surgery, my role in managing your pain is crucial.
1. Protective Oral Appliances
Many patients with facial pain clinch or grind their teeth due to stress and pain, which only makes the situation worse. I can create custom orthotics or night guards. These devices stabilize your jaw and prevent the secondary muscle pain that often accompanies neuralgia.
2. Restoring Harmony to the Bite
As a cosmetic dentist, I focus on the “bite”—how your top and bottom teeth come together. If your bite is misaligned, it causes constant stress on the facial muscles and nerves. By correcting your bite through restorative procedures (like crowns or veneers) or adjusting the occlusion, we can reduce the overall “noise” and stress in your facial region. This doesn’t “cure” the nerve compression in the brain, but it removes external triggers that spike the pain.
3. Medication Management
For the nerve pain itself, standard painkillers like ibuprofen usually don’t work. Doctors often prescribe anticonvulsant medications. These drugs calm the nerve down and stop it from misfiring. I work closely with your medical doctors to ensure your oral health is maintained while you are on these medications, as some can cause dry mouth, leading to cavities.
Living with Facial Neuralgia
Receiving a diagnosis of facial neuralgia can feel overwhelming, but I want to assure you that it is manageable. The goal of treatment is to reduce the pain to a level where you can enjoy your life again.
Here are a few tips I give my patients in Northridge to help manage their daily comfort:
- Identify Triggers: Keep a pain diary. Does cold wind set it off? Wear a scarf. Is it cold drinks? Use a straw.
- Soft Diet: During a flare-up, stick to soft, nutritious foods to minimize chewing effort. Smoothies and soups are great options.
- Stress Reduction: Stress makes pain perception worse. Techniques like meditation or gentle yoga can help lower your overall sensitivity.
- Oral Hygiene: It can be scary to brush your teeth if that triggers pain. However, neglecting hygiene leads to real dental problems. I can recommend ultra-soft brushes or special rinses to keep your mouth clean without the pain.
The Connection to Cosmetic Dentistry
It might seem odd to discuss cosmetic dentistry in a post about pain, but they are deeply connected. Pain affects how you look. When you are in pain, you grimace, you clinch, and you hide your smile. Chronic pain can actually age your face.
Once we have managed the pain and stabilized your condition, my joy is helping you smile again—literally. Cosmetic dentistry is not just about vanity; it is about restoration. Whether it is fixing teeth worn down from years of grinding due to pain, or simply giving you the confidence to show the world a happy face again, I am here for that journey.
For more in-depth medical information regarding the neurological aspects of this condition, I recommend reading this article from the Mayo Clinic regarding Trigeminal Neuralgia. It provides excellent supplementary information to what we have discussed today.
Why Choose a Local Expert?
Navigating facial pain requires a team. You need a neurologist, perhaps a pain management specialist, and absolutely, a knowledgeable dentist. By choosing a local provider in Northridge, you ensure that you have support close to home. When you are in pain, you do not want to drive across Los Angeles in traffic.
I have spent years building relationships with medical specialists in the San Fernando Valley. If I suspect your pain is beyond the scope of dentistry, I can guide you to the right experts immediately. We operate as a community here, ensuring you get the best care possible.
Your Smile is Worth Saving
I hope this article has shed some light on the complex world of facial pain. If you or a loved one are experiencing symptoms that sound like trigeminal neuralgia, please do not suffer in silence. The worst thing you can do is ignore it or assume it is “just a toothache” that will go away.
At my practice here in Northridge, we combine advanced technology with a compassionate, human touch. I look at the whole person, not just the teeth. We will sit down, discuss your symptoms, review your history, and create a plan that addresses the root cause of your discomfort.
We are conveniently located for patients in Northridge, Reseda, Winnetka, and the surrounding communities. My team and I are ready to listen. Let us help you get out of pain and back to smiling with confidence.