Trigeminal neuralgia (TN) is among the most painful afflictions known. It is characterized by sudden attacks of pain that are typically brief, lasting only seconds to two minutes. These attacks are severe and described as intense, stabbing or electrical shock-like. TN sufferers often endure years of suffering and misdirected treatments before the disease is recognized. Some of the erroneous diagnoses often encountered include various dental diseases, temporomandibular joint disorders, paranasal sinus infections, ophthalmic (eye) pain syndromes, temporal arteritis, ice pick-like migraine pain, facial migraine, myofascial pain, idiopathic facial pain and psychological disorders. Even today patients have undergone several unnecessary and useless “treatments” before the TN was accurately diagnosed. Some misdirected interventions include dental extractions, root canals, nasal sinus surgeries, biopsies, salivary gland procedures and medical treatments involving antibiotics and narcotics. The difficulty in diagnosing TN is in part due to the lack of confirmatory clinical, laboratory or radiological tests, periods of spontaneous remission that may be confused with a cure for the disorder, and the relative rarity of TN.This is an evidence based presentation aimed at managing trigeminal neuralgia in a systematic way in a dental office which reviews the common management strategies and their success.

Key Words Trigeminal Neuralgia, Diagnosis, Varbamazepine, Phenytoin, Alcohol, Cryosurgery.