Ms. Mao is 56 years old, ten years ago the left side of her teeth are painful from time to time, the left side of her face like being cut by a knife, but she always thought it was a toothache. Slowly most of the teeth on the left side were pulled out, but the pain was still severe. It was only when she was diagnosed recently that she realized she didn’t have toothache, but trigeminal neuralgia. There are many patients like Ms. Mao, who often mistook it for a simple toothache at the beginning of the disease, and the pain did not go away even after the tooth was extracted, and finally found out that the culprit was trigeminal neuralgia after several visits. How to distinguish trigeminal neuralgia from toothache? Toothache: As the saying goes, “toothache is not a disease, but pain is fatal”, toothache is generally a persistent, localized soreness. Toothache is mainly caused by the inflammation of the tissues around the tooth or the gums, but it can also be caused by the lesion of the tooth root, and the pain will be aggravated by hot or cold stimulation. In terms of treatment, some anti-inflammatory drugs, such as metronidazole and fenpropathrin, can be taken to relieve the toothache. Toothache can usually be completely relieved after tooth extraction. If it cannot be relieved, it is important to consider whether it is trigeminal neuralgia. Trigeminal neuralgia: It belongs to a brain neurological disease, which mostly occurs in middle-aged and elderly groups, and often manifests as recurrent paroxysmal severe pain within the trigeminal nerve distribution area of one side of the face. It is like a lightning-like, knife-cutting, burning-like intensity. It is unbearable. Because of the presence of trigger points, it can cause patients to trigger pain when talking, washing their faces, brushing their teeth or when a breeze hits their face, or even when walking. The pain lasts for a few seconds or minutes, with periodic episodes of pain, with intervals between attacks as normal. Initially, trigeminal neuralgia treatment can be done with oral carbamazepine or oxcarbazepine drugs to achieve effective pain relief. If the drugs are ineffective or the side effects are too great, surgical treatment can be performed. If trigeminal neuralgia is clearly found to be caused by blood vessel compression of the trigeminal nerve, microvascular decompression can be used to completely eliminate the pain. If tumor-occupying compression or other lesions are detected, appropriate surgical treatment measures can also be taken.