The simple treatment of chronic facial pain due to trigeminal neuralgia with dental occlusal equilibration

Background: Trigeminal neuralgia (TN) is the most common cranial neuralgia in adults, with a slightly higher incidence in women than in man. This chronic pain condition affects the trigeminal nerve, also known as the 5th cranial nerve. Antiseizure drugs are the main biomedical treatment of TN. However, TN is not the only source of chronic facial pain (CFP). Background persistent idiopathic facial pain (PIFP) is also a chronic disorder. The underlying pathophysiologies of TN and PIFP are still unknown. Occlusal equilibration appliance (OEA) will stop bruxism by relaxing all mastication muscle especially, The Lateral Pterygoid muscle. The posterior trunk of the mandibular division of the trigeminal nerve normally descends deep to the lateral pterygoid muscle. In three of 52 dissections the three branches of the posterior trunk were observed to pass through the medial fiber of the lower belly of the lateral pterygoid muscle. Case description: A 70 year-old Thai female with left facial pain was diagnosed by a neurologist with TN 4 years prior to seeking occlusal equilibration. The cause of facial pain was treated with occlusal equilibration appliance. Conclusion: A complete dissipation of pain was achieved after using occlusal equilibration appliance for 2 weeks and 3 days. The present article is the one of the first to demonstrate the efficacy of occlusal equilibration appliance treatment for chronic facial pain. As the present article shows, OEA treatment affects TN and CFP successfully. However, additional large-scale studies are necessary to validate the efficacy of OEA in TN and CFP treatment.