Master Chen, 61 years old, has been suffering from “toothache” for 20 years. At first, the lower right side of his teeth in his mouth was often painful, like many needles sticking in the flesh. Later, a small cluster of sharp fleshy buds seemed to grow between the first and second big teeth, causing lightning-like pain when he touched it gently while eating or brushing his teeth, and radiating to the front of his right ear. The pain seemed to go away after having a large tooth extracted by the dentist at the dental clinic. The pain returned after three months, and although the dentist took x-rays to make sure the root of the tooth was fine, Master Ding asked the doctor to remove another large tooth next to it. 20 years he went from one dental clinic to another for this purpose, and finally had all the teeth on the lower right side removed, but the toothache still haunted him, causing him to bang his head against the wall during episodes of severe pain, and even to think of suicide. In March this year, Mr. Chen came to the neurosurgery department of Shengli Oilfield Central Hospital and was diagnosed to have trigeminal neuralgia. He underwent trigeminal nerve microvascular decompression surgery under general anesthesia. Mr. Ding felt that he only slept on the operating table for a while, and when he woke up, the pain disappeared, and his facial sensation was not affected. How can it be trigeminal neuralgia when it is obviously a toothache? Here, we can tell you that there are twelve pairs of brain nerves running through the left and right sides of the brain, and the fifth pair of brain nerves is divided into three branches after leaving the brain, so it is named trigeminal nerve. These trigeminal nerves manage the sensation of the skin and mucous membranes on one side of the head and face, such as the upper and lower gums, lips, cheeks, orbits and forehead, respectively. Branch II and III neuralgia manifests as upper or lower tooth pain. Therefore many patients who have toothache caused by trigeminal nerve will first go to dentistry to see a doctor. In fact, toothache and trigeminal neuralgia are different. Toothache is a kind of local inflammatory persistent gum pain, while trigeminal neuralgia is an epileptic seizure-like sharp pain like stabbing, lightning or cutting, and often there are “trigger points” like the kind of “meat buds” that cause severe pain on half of the face when touched, such as Master Ding. The pain is so intense that some patients may even think of dying, so trigeminal neuralgia is called “the first pain in the world”. According to medical data, more than 90% of patients with trigeminal neuralgia are due to the sclerosis of cerebral blood vessels that are displaced on the nerve when they get older, as well as other rare causes such as tumor or virus invasion of the nerve or degeneration of the nerve itself. Doctors can block the nerve conduction to stop the pain by various methods, among which microvascular decompression is the most scientific and advanced treatment for the cause of trigeminal neuralgia that has been unanimously recognized in China and abroad since the 1960s. Microvascular decompression refers to the surgical microscopic removal of blood vessels located in the roots of the trigeminal nerve, facial nerve, linguopharyngeal nerve and other brain nerves that are abnormal and cause pressure on the brain nerves, thus eliminating the clinical symptoms. Trigeminal neuralgia is a treatable disease, but many people lack knowledge about it, and even many clinicians misdiagnose this disease. Therefore, patients with half of the face pain or “toothache” must not forget to go to the neurosurgery department of a regular tertiary hospital to avoid delaying the diagnosis and treatment.