Identifying Malpractice in Trigeminal Neuralgia

Jeff Rabinowitz

Dental Expert Witness

Post Publish Date

May 3, 2022

Post Categories

Determining whether or not dental malpractice has taken place can be a challenge in almost any case, but even more so when the claim involves a specific injury or condition requiring detailed medical knowledge, such as Trigeminal Neuralgia. In such cases, engaging a dental expert witness to assess the nature and etiology of the Trigeminal Neuralgia is more important than ever—since only an expert will have the authority, experience, and knowledge necessary to support or contest the claim at hand.

Malpractice suits involving Trigeminal Neuralgia are challenging to assess, since this condition can be particularly difficult to diagnose accurately. Fortunately, I’ve consulted on many cases involving malpractice suits over Trigeminal Neuralgia in the past, and I’m here to answer your questions about it so that you can retain a reliable dental expert witness for your case.

What Is Trigeminal Neuralgia?

Trigeminal neuralgia is a condition characterized by significant pain associated with the trigeminal nerve (the Fifth Cranial Nerve). The pain, often severe and debilitating, can be of unknown causation, or it can be associated with facial or dental trauma or oral surgical injury. The trigeminal nerve is responsible for transmitting sensations from the face to the brain.

The trigeminal nerve includes three branches:

  • The mandibular nerve (inferior alveolar serving the lower jaw and face)
  • The maxillary nerve (serving the upper jaw and face)
  • The opthalmic nerve (serving the upper face and the eye)

Most frequently encountered in dentistry is Trigeminal Neuralgia involving pain of the lower and/or upper jaw. While at times of unknown cause, it is not uncommon for the painful symptoms of Trigeminal Neuralgia to follow improper dental implant placement, wisdom tooth removal, or root canal therapy—where traumatic surgical injury to the nerve itself is associated with the painful post-treatment symptoms.

What Are the Symptoms Associated with Trigeminal Neuralgia?

Any kind of injury or trauma to the trigeminal nerve can potentially disrupt the information and messaging reaching the brain. As a result, a person with Trigeminal Neuralgia can experience extreme pain and discomfort in and around their face, which is typically chronic and very challenging to effectively treat. Patients may experience shooting pains, electrical sensations, and facial spasms.

The pain caused by trigeminal neuralgia is often described as:

  • Debilitating
  • Acute or severe
  • A shooting or stabbing sensation
  • Comparable to the feeling of an electric shock

This pain can appear intermittently, and may last from just a few seconds to over several minutes. It often appears in the following areas:

  • Teeth
  • Cheeks
  • Jaw
  • Gums
  • Lips
  • Eyes & forehead (less common)

Pain from Trigeminal Neuralgia doesn’t always stay in the same place. It may affect only one area of the face at a time, or move around the face in patterns. The unpredictable nature of this pain can sometimes make diagnosing Trigeminal Neuralgia difficult.

Finally, pain caused by Trigeminal Neuralgia can be triggered or exacerbated by daily activities that do not typically cause pain for others, such as brushing one’s teeth, chewing food, or even speaking in regular conversation.

Person holding face in pain from trigeminal neuralgia symptoms

What Causes Trigeminal Neuralgia?

Several dental procedures can inadvertently initiate or aggravate Trigeminal Neuralgia when performed incorrectly. However, it is vital to note that Trigeminal Neuralgia can occur for other reasons as well.

In fact, it is estimated that at least 15,000 people suffer from Trigeminal Neuralgia in the US alone, many of them as the result of factors unrelated to dental treatment or procedures. Trigeminal neuralgia may result from:

  • A blood vessel or tumor putting pressure on the trigeminal nerve
  • Multiple sclerosis (which can damage the sheath protecting the trigeminal nerve)
  • Brain lesions
  • Stroke
  • Trauma to the face

What Dental Treatments Can Cause Trigeminal Neuralgia?

Trigeminal Neuralgia is sometimes the result of dental malpractice as well. When this is the case, it is often as the result of complications during one of the following procedures:

  • Placing dental implants in the lower jaw
  • Root canal treatment in the lower or upper molars or premolars
  • Extractions of the lower molars, especially wisdom teeth

Some pain and discomfort is typically to be expected after the procedures listed above—but if one experiences sudden, shooting pains during or after a dental procedure that continue or flare up long after the normal recovery period, it’s possible that they are experiencing symptoms of Trigeminal Neuralgia.

What Can I Do If I Develop Trigeminal Neuralgia After a Dental Procedure?

If you experience severe, long-lasting, or recurring pain in the face after a dental procedure, try taking over-the-counter painkillers. If these fail to relieve your symptoms or if symptoms persist or worsen, the next step is to consult your dentist or physician for further evaluation.

Remember: Trigeminal Neuralgia can be extremely difficult to diagnose properly, since the pain it causes can vary widely from one person to the next. For this reason, evaluation by a dentist or physician who is well versed in facial pain, neurology, and dentistry is recommended to confirm the diagnosis.

And although challenging to treat, accurate diagnosis by a specialist in this area—often a neurologist working with pain management dentists, physicians, and neurosurgeons—can lead to effective treatment through pharmacologic and/or surgical management (nerve blocks, microvascular decompression, rhizotomy, stereotactic radiosurgery).

Furthermore, even in cases where Trigeminal Neuralgia has been confirmed, it can be extraordinarily difficult to prove that it is the result of dental malpractice. Doing so typically requires the plaintiff to effectively rule out all other potential causes, which will almost certainly require testimony from a dental expert witness.

Dental expert witnesses are also frequently retained by practices defending against malpractice suits over Trigeminal Neuralgia. Our knowledge allows us to review the details of a case and determine whether the defendant performed their duties properly.

Find Support for Your Trigeminal Neuralgia Case

Whether you represent the plaintiff or the defendant in a case involving Trigeminal Neuralgia, you’ll want to make sure you can present the facts of your case accurately and support them with compelling data. That’s why having a dental expert witness is so vital for these types of cases.

Have more questions about Trigeminal Neuralgia or about a case you’re involved in? Contact me to learn more about this complex condition and find the best way to proceed.

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dr Jeff Rabinowitz

Jeff Rabinowitz

After earning his Bachelors and Doctoral degrees from the University of Pennsylvania, Dr. Rabinowitz completed residency training at the Mount Sinai Medical Center in New York City. He subsequently completed Fellowship training in Implantology and Periodontics at New York University and in Parenteral Conscious Sedation at St. Joseph and Brookdale Medical Centers. He established a multi-specialty group practice in Manhattan, he taught at Mount Sinai and he has pursued years of extensive advanced education programs and has maintained an active practice in implantology, complex restorative and prosthodontic care, periodontics, oral surgery, bone and soft tissue grafting, Invisalign and cosmetic dentistry. Dr. Rabinowitz holds a faculty appointment, teaching dental students at Touro College of Dental Medicine.

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