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Trigeminal neuralgia is a facial pain condition. The trigeminal nerve carries sensation from your face, and when it misfires the result is sudden, brief, electric-shock-like pain, almost always on one side. A light touch, cold air or chewing can set it off.
It is not a toothache, though it is often mistaken for one, and some people have dental treatment before the real cause is found. The pain is usually felt in the cheek, mouth or gum, so teeth get the blame.
It is also not imagined. There is usually a physical explanation: Migraine Canada lists a blood vessel loop pressing on the nerve, a tumour, multiple sclerosis and past viral infection among the causes.
The pattern varies between people, and can change over the years.
Some things cannot be changed:
Little here is about lifestyle. What can often be worked on, with a health care team, is narrower:
Migraine Canada describes this as a clinical diagnosis, based on how you describe the pain and on a neurological examination. Your clinician will ask what triggers attacks and whether there are pain-free spells, and will check facial sensation, jaw strength and eye movements. Dental causes are usually considered first. An MRI is commonly ordered to look for a vessel pressing on the nerve, MS or a tumour, and Migraine Canada notes the scan very often comes back normal, which does not mean the pain is not real. Referral to a neurologist, pain clinic or neurosurgeon follows if a procedure is considered.
Care usually starts with medicine and moves to procedures if pain persists. A health care team may discuss:
Which route fits, and when, is a decision for you and your own clinician.
The basic numbers are missing. No Canadian prevalence figure has been published, and the best global estimate comes from a 2026 review of 17 studies going back to 1945 in 12 countries, landing on an annual prevalence between 15 and 134 per 100,000. Diagnosis is often slow, since facial pain is easily blamed on teeth and the MRI is frequently normal. The mainstay medicines were developed for epilepsy, and access to surgery is concentrated in a few Canadian centres. Research is looking at better diagnosis, at medicines designed for this nerve pain, and at who benefits from which procedure.
Studies are how those questions get answered. Taking part is voluntary, informed consent comes first, and you can stop at any time without affecting your regular care. No one can say whether a study will help you personally.
This page is written in plain language for people considering clinical research. It is general health information, not medical advice, and it does not replace a conversation with your own doctor or nurse practitioner.
There is no Canadian figure. The best available estimate is international: a 2026 systematic review in the Journal of Clinical Neurology pooled 17 studies from 12 countries covering 1945 to 2024 and found an annual prevalence of about 45 per 100,000 people, a lifetime prevalence of about 108 per 100,000, and about 25 new cases per 100,000 person-years. New cases were roughly twice as common in females. None of the studies were Canadian, so these figures describe the condition internationally rather than in Canada.
A normal MRI is common in trigeminal neuralgia. Migraine Canada states that an MRI may be done to look for nerve compression but very often comes back normal, and that the diagnosis is clinical, based on how you describe the pain and on a neurological examination. The scan is looking for specific things: a blood vessel pressing on the nerve, changes from multiple sclerosis, or a tumour. Not finding one of those does not change the diagnosis, though it can affect which treatments are considered.
No, although it is often mistaken for one. The pain is usually felt in the cheek, mouth or gum, so many people see a dentist first and some have dental treatment before the cause is identified. The pain comes from the trigeminal nerve, which carries sensation from the face. Dental causes are still worth ruling out, because tooth and jaw infections cause facial pain too and need different treatment, which is why facial pain with fever, swelling or a discharging tooth should be assessed promptly.
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