How to Look After Painful Teeth If You Have Trigeminal Neuralgia

Brushing your teeth is possibly one of the biggest pain triggers when you have trigeminal neuralgia. It can cause excruciating pain, but we do still need to take care of our teeth.

This post has tips for coping with mouth and teeth pain, tips for cleaning teeth and some suggestions which might be useful when you visit the dentist.

Tips for coping with mouth and teeth pain from trigeminal neuralgia. Picture of sad looking, red haired girl holding her face as if she has toothache.

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Coping With Mouth and Teeth Pain if You Have Trigeminal Neuralgia

Trigeminal neuralgia can cause a shocking, burning or aching type of pain in any area of the face. Very commonly it can be felt in the mouth with the teeth, gums, cheek, tongue or palate being affected. It can feel like severe toothache making it extremely difficult to look after your teeth properly.

If your medication is not helping enough, there are a few things which might help.

Heat Therapy

Many people find heat helpful. Try holding a hand warmer, hot water bottle or even just a damp warm flannel against your face. Swilling some warm liquid inside your mouth might also help.

Cold Therapy

Some people can’t stand cold, but for others, it can help. Hold a cool pack on your face. You could make your own with a bag of frozen peas wrapped in a tea towel.

Combination of Heat and Cold

Alternating between heat and cold can also sometimes help.

Numbing the Mouth

Mouthwashes and sprays which are normally for sore throats can give a numbing effect. The spray can be directed at the most painful part.

Dental Gel

A dental gel containing topical anaesthetic may also help. The Orajel pictured below contains 10% Benzocaine which could give some relief.

Read the instructions and use exactly as directed. Overusing topical anaesthetics such as Benzocaine can be very dangerous.

Dry Mouth

Dry mouth is often common amongst people with trigeminal neuralgia as it’s a side effect of many medications. It can be painful and distressing but it can also lead to tooth decay, therefore you can’t ignore it.

Dealing With Cleaning Your Teeth When You Have Trigeminal Neuralgia

It can feel impossible at times to put a toothbrush anywhere near your teeth when you have trigeminal neuralgia. But dental health is important and despite the pain, you still need to look after your teeth.

Everyone wants pearly white teeth, but we need to keep our teeth and gums healthy for the sake of our general health too. If we develop gum disease, we are at risk of developing other health problems such as heart disease, strokes, diabetes and rheumatoid arthritis. Read more about this on the NHS website.

Cleaning your teeth when you have trigeminal neuralgia. picture of two toothbrushes and a tube of toothpaste with blue toothpaste.

Tips for Cleaning Your Teeth When You Have Trigeminal Neuralgia

The following tips might help you to look after your teeth, despite your trigeminal neuralgia being painful.

Use a Numbing Mouthwash or Spray Before Brushing

Use a numbing mouthwash or spray before brushing as it could allow you to brush your teeth with less pain. It’s short-lasting, but it might allow you to get the job done.

Which Type of Toothbrush Should You Use if You Have Trigeminal Neuralgia?

Only use a soft toothbrush with a small head. A child’s brush might be best because of the size. A silicone toothbrush might also feel better than the nylon bristles of a normal brush. A silicone finger cover could also be used – they’re normally used for babies and pets, but you might find they are gentler on your teeth and gums especially on bad days.

Which Toothpaste is Best?

Only use a sensitive toothpaste. Avoid harsh, abrasive or whitening toothpastes because they will aggravate the nerves more.

Use Warm Water

Cold is often a trigeminal neuralgia trigger, therefore, don’t use cold water when you’re brushing your teeth. Use either room temperature or warm water.


Dentists say that in order to look after your teeth properly, you should floss at least once a day, but if you have trigeminal neuralgia, you’ll possibly find flossing much too painful. I’ll put my hand up and admit that I don’t floss as often as I should. However, if food gets lodged between my teeth, my facial pain gets out of control. If I floss and manage to remove that offending piece of food, it often starts to relieve some of the pain.

Before attempting to floss, use the numbing mouthwash or spray.

Water Pik

Water piks can be used to clean plaque and debris from between the teeth. It might be easier than flossing, but only use it with warm water.

On the Days When You Cannot Look After Your Teeth Because Your Trigeminal Neuralgia is too Painful

On days when you can’t brush or floss at all, try using dental wipes or a mouth swab which has been soaked with mouthwash. Or simply swish with a mouth wash. It’s better than nothing.

Coping with dentist appointments  Picture of a toothbrush and some dental instruments.

The Dreaded Dentist Visits When You Have Trigeminal Neuralgia

Dental appointments can be frightening when you have trigeminal neuralgia, but they are extremely important. You need to ensure your teeth are healthy. Dentists also check lymph nodes and look for any oral abnormalities which could indicate a serious health problem. So, please, don’t put off going to the dentist.


If you know that a visit to the dentist will cause a flare up which will possibly be long lasting, speak to your doctor before you go. They may consider increasing your TN meds temporarily or prescribe something else which might help. If you feel extremely nervous, ask your doctor to prescribe something to help keep you calm because stress and anxiety are pain triggers.

As well as your normal meds, take standard pain medication like codeine, paracetamol, Tylenol or ibuprofen before and after the appointment. Over the counter pain medication doesn’t help trigeminal neuralgia, however, they can help normal muscular and dental pain. Sitting in the dentist’s chair with your mouth open wide will cause muscular pain. Tensing up, anxiety, fear and stress about being there, will also possibly cause pain, therefore, standard pain medication could help.

Find a Good Dentist You Can Trust

Some dentists have good knowledge about trigeminal neuralgia, others don’t. If they don’t, it doesn’t necessarily mean they’ll not treat you well. If they listen to you and try to learn about the condition, they might turn out to be the best dentist you could ever have. Provide them with information about trigeminal neuralgia from your country’s Facial Pain or Trigeminal Neuralgia Association.

If they’re not interested in learning about your condition, find a different dentist.
If they have no compassion or empathy, find a different dentist.
If you feel you can’t trust them, find a different dentist.

Don’t Go to the Dentist on a Very Bad Day

Talk to the dentist about the unpredictable nature of your pain and ask if you can cancel your appointment if you’re having a particularly bad day. Dentists don’t want to hurt you and if you’re in severe pain before getting there, it would make their job more difficult.

Arrange Short Treatments

Don’t plan for a lot of work to be done during one appointment. Shorter appointments can work better.

Preplan Hand Signals to Take Breaks

Take breaks throughout the treatment if you need to. Even just minute’s rest can help. Arrange to use hand signals so that whenever you need a break, the dentist will stop.

Explain Your Pain

This might sound obvious, but explain what your pain is like and exactly where it is. If you have a trigger point or one particular area which is worse than the rest, tell your dentist.

Start at the Good Side

Always ask the dentist to work at the good side first. Get that done before going near your bad side.

Topical Anaesthetic

Ask the dentist to use a topical anaesthetic (numbing gel or mouthwash) before starting to examine or work on your teeth.

Local Anaesthetic Injection

If you need an injection, ask the dentist to avoid your trigger points if possible.

According to ‘Striking Back, the Trigeminal Neuralgia and Facial Pain Handbook’, Marcaine is the anaesthetic of choice. But according to the Facial Pain Association, Mepivacaine or Carbocaine, can also be used.

(Striking Back is no longer being printed, however, it is available in digital format here)

Anaesthetic to Avoid

You should ask your dentist to ensure that Epinephrine is not added to whichever local anaesthetic is used. Epinephrine can make the numbness last longer, but it can also trigger nerve pain.

General Anaesthetic

If you struggle with dentist appointments and need major dental work, ask to be referred to a hospital where they could give you a general anaesthetic before the treatment.

Trigeminal neuralgia or toothache. How can you tell the difference. Photo of a woman with her hand at her mouth.

Is it Toothache or is it Trigeminal Neuralgia?

It’s often difficult to tell the difference because trigeminal neuralgia can often feel like toothache.

When to See the Dentist

See the dentist urgently if you have swelling, pus, a bad taste or smell because, most likely, you have an infection.

If your dental pain is relieved by a standard painkiller, it’s unlikely to be trigeminal neuralgia, therefore see the dentist.

It’s also wise to see a dentist if the pain is new as it may be a dental problem.

Don’t Get Any Experimental Treatment

A good dentist will be able to tell if there is a dental problem by examining you and taking x-rays.

If you have a good dentist who says there’s no dental problem after a thorough examination and x-rays, trust them. Don’t have root canals or extractions done just to see if they will take away your pain. They won’t.

And don’t trust a dentist who suggests treatment or extracting teeth just in case. If there’s no sign of a dental problem when they examine your teeth and take x-rays, then you don’t need treatment.

Cartoon pictures of teeth and toothbrushes.

Prevention is Better Than Cure

Trying to look after your teeth can be a nightmare when your trigeminal neuralgia is painful but prevention is always better than cure. Hopefully, some of the tips in this post will help you.

If you have any other tips, please let me know so that I can add them to this post.

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3 thoughts on “How to Look After Painful Teeth If You Have Trigeminal Neuralgia

  1. My goodness, this must be awful to experience. I can only imagine what it’s like, but I can see why it could make looking after your teeth quite challenging and unpleasant. A numbing mouthwash or spray sounds well worth trying, and I love your tips for dealing with dental appointments, too. Hand signals for taking a break would be helpful. It’s not always easy to get across what you need when you’ve got hands in your mouth. I sadly find many dentists aren’t forthcoming with offering numbing/local anaesthetics, not even offering it as an option to ask if you’d like it for injections. The option might be there for a check up, especially with a condition like this, so I hope more dentists can be aware of TN so they can make some adjustments to help their patients. xx

  2. I’m going through this now. U sure if it’s sinus, dental or neuralgia. 3 lots of antibiotics as no one will see me but I finally have an appt on 8th to hopefully rule infection or dental problems out. It’s been excruciating.

  3. Tiffany Pieczynski

    This is what I’m going through daily. I’ve never thought of using mouthwash before brushing my teeth but now I’m open to trying anything that helps. I mean I have no room to be put through much more pain. I mean brushing hurts me, wind basically anything causes extreme pain. It’s getting to the point I want the shortest shower possible….it’s difficult to sleep on my side or at all. I’m on the highest amount of medication possible…..I feel unable to just livey life without feeling like a drill is turning off and on in my head on one side or the other …..

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