Michael E. Foster, D.D.S.
Foster Family Dentistry
5704 Hwy. 290 West
Austin, TX 78735
512-892-2273
http://www.fosterfamilydentistry.com/DrFoster.htm
Transcript: A dentist’s role in diagnosis
Well the greatest gift a dentist can provide a patient that has potentially, that’s a trigeminal neuralgia patient, would be a correct early diagnosis. Frequently a patient comes in and says “Doc, I’ve got a toothache. You know, I’m hurting real bad. Can you help me out here?” And typically a dentist will take a look. We all do the same thing. You know. We want to get an x-ray, take a look at the tooth. And sometimes it’s just not very obvious. Many times these patients come in and they’ve had a root canal or two and it’s on the same side, the same area. And you know a smart dentist will take notice of this and question why these were done, when they were done and then will go in and do his test and if for some reason the tooth does not appear to have any obvious dental problems a smart dentist would sit back and say “Maybe this is potentially a neuropathic problem.”
Often, when a patient comes in they’re having somewhat of a pretty severe toothache, pain, and they may be desperate and they’ll almost demand that the dentist do something. And unfortunately, a lot of dentists when they do something it’s either an extraction or a root canal. And that’s great if that’s what’s required. If it’s not, then four, five, six, eight weeks go by and everything is basically pretty good and then the pain usually comes back. And then they think well maybe possibly they got the wrong tooth. So at that point, then they may do it again. So if a patient’s not careful and if they’re too demanding they will end up either what we call serial root canals and then serial extractions which means you’ll have one side of the mouth with an awful lot of dentistry that really didn’t require to be done and it was actually a neuropathic problem which could be the classic trigeminal neuralgia or the unclassic trigeminal neuralgia.
So, the best thing a dentist can do is listen to the patient and ask questions. Don’t get intimidated by the patient. Ask the questions several times until you get a good answer.
One of the problems that I have seen with trigeminal neuralgia patients is that they come in and they have a whole list of things. They’ll talk about different things. And actually the dentist is getting behind. He wants to move on with doing the classic dental work but the patient keeps talking about this and that and sometimes it makes it kind of hard so the patients need to be clearer. They need to come in with information about that particular problem. What causes it? When it happens? How long has it been happening? And don’t get into a whole lot of other extraneous problems that may or may not have something to do with that.
So that’s about the best thing I can come up with is trigeminal neuralgia is not seen very often. A typical toothache is a very common problem and dentists get sucked into that trap. We do what we do often and we see what we see often. And trigeminal neuralgia is not a very common problem so it’s very easy to overlook.