Trigeminal neuralgia, with an incidence of 1 in 1,000 in the general population, is a lightning bolt of pain that strikes the jaw and face, yet more than half of all patients have been misdiagnosed as having a toothache. However, more than half of the patients have been misdiagnosed as having toothache. Without proper treatment, the pain only gets worse and worse, and the pain becomes unbearable for normal people. The treatment methods including medication, interventional and surgical methods have their own advantages and disadvantages, and individualized treatment plans should be developed according to the patient’s etiology, condition and age. The typical symptom is toothache After understanding that the patient had facial pain for several months, the pain still did not disappear after two teeth were extracted, so he went to the hospital again to extract the teeth, and finally all the teeth in a row were extracted, but his facial pain was still there. However, his facial pain still persisted. The patient had no choice but to go to Liu Zhiming, the director of the department, and was diagnosed with trigeminal neuralgia after questioning and investigation. The department often receives patients who have their teeth extracted because of facial pain. These patients initially thought that their facial pain was caused by toothache, but the pain did not disappear after the tooth was extracted. Liu Zhiming pointed out that clinical statistics found that about nearly 50% of trigeminal neuralgia patients mistakenly thought they were suffering from toothache, so patients preferred to patronize the stomatology department. In fact, about 90% of patients are suffering from trigeminal neuralgia due to vascular compression of the nerve 1-2 cm from the brainstem, and a very small number are suffering from pain caused by tumors. Mostly seen in middle and old age “Trigeminal neuralgia rarely gets better naturally without treatment; it deepens step by step and develops to the point where patients often feel worse than death.” Liu Zhiming, director of the trigeminal neuralgia, there are two main types of causes, one is primary, to date it is still difficult to find the real cause; the second belongs to the secondary, that is, from the trigeminal nerve from the brain bridge to the pathway of the innervation of the facial skin sensation is stimulated by lesions, compression and trigeminal neuralgia. “The incidence of trigeminal neuralgia reaches one in a thousand of the general population, which is already a very high percentage, and is more often seen in middle-aged women, or related to the endocrine level of the human body.” Liu Zhiming, director of the disease, with the increasing age, the incidence of this disease is also gradually climbing. Three self-identification trigeminal neuralgia Timely identification of toothache and trigeminal neuralgia is very important for clinical treatment, the public can simply self-identify according to the following methods: 1, if the toothache does not improve after taking ordinary painkillers, it can be ruled out as periodontal and other inflammatory pain, but nerve pain; 2, during the examination, if no caries, periodontitis and other related inflammatory diseases are found, but the tooth is still painful, it is It may be caused by trigeminal neuralgia or tumor; 3. From the point of view of pain performance, dental inflammation and chronic pain will generally show continuous pain, while typical trigeminal neuralgia is lightning sharp pain during the attack, which usually lasts for a few seconds, and several times a day, making it unbearable. ”Overall, trigeminal neuralgia is a recurrent paroxysmal pain that occurs in the distribution of the trigeminal nerve, with the three branches of the trigeminal nerve located in the frontal, maxillary, and mandibular skin, as well as the upper and lower gums. Trigeminal neuralgia attacks are often without aura, sudden lightning-like as if knife, burning, pins and needles, electric shock-like pain, severe and unbearable, no other local lesions, no bleeding, swelling, numbness and other phenomena and feelings.” Liu Zhiming, the director of the toothache, on the other hand, is mostly a persistent attack, and the condition will be aggravated by hot and cold stimulation. ”The treatment of trigeminal neuralgia should be broken down according to the patient’s etiology, condition, age and other factors before developing a personalized treatment plan. “The first step is to conduct a comprehensive and detailed examination to determine whether the condition is primary or secondary. If it is secondary, the exact cause should be found out, and if it is caused by a tumor, the tumor should be surgically removed, and if it is inflammatory, it should be treated with anti-inflammatory and pain relief.” The treatment of primary trigeminal neuralgia generally starts with medication. Liu Zhiming, the director, said that drug treatment can only have a purely pain-relieving effect, and too much use may cause damage to the liver and kidneys. Because the cause of primary trigeminal neuralgia is mostly caused by microvascular compression of the trigeminal nerve into the brainstem segment. Therefore, the most important means to completely cure trigeminal neuralgia is to relieve microvascular compression by targeting the cause. Microvascular decompression is currently the safest and most effective surgical treatment method, while other surgical methods are less frequently used due to poor treatment effect and many surgical complications. Microvascular decompression is performed under general anesthesia by making a 5-cm incision behind the affected ear and a 2-cm cranial window, and using a special material under the operating microscope to open the blood vessels compressing the trigeminal nerve and the trigeminal nerve. The entire operation is completed within 1 hour with little or no damage to the patient’s nerves and brain tissue. The pain disappears and is permanently cured in the vast majority of patients after surgery.