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Practice Practice Pointer

Orofacial pain

BMJ 2018; 361 doi: (Published 16 May 2018) Cite this as: BMJ 2018;361:k1517
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A strategy for identification and initial management of orofacial pain

Rapid Response:

Trigeminal neuralgia: Orofacial pain

I assume that Trigeminal Neuralgia (TN) is the area of orofacial pain not discussed in this article. This is presumably because it has required surgical treatment in some past cases. The surgery is risky, expensive and has a success rate in pain relief about 65%.

Medication with tegretol, gabapentin and/ or amitryptiline is fraught with the side effects of these drugs and is often unsuccessful.

There is another way using a food additive E-304 as a daily oral intake of around 2.4gm. In many cases this can achieve full pain control in a few days without any other medication. It is the subject of a clinical trial in India and is referred to in an article describing cases @ .

Treated in this way it is a simple matter for a GP to treat and therefore could have been covered in this BMJ article.

Letters in the British Dental Journal in 2012, 2014 and 2016 refer.

Competing interests: No competing interests

22 May 2018
Andrew J C Carmichael
Retired Dental Surgeon Charity chair
Parkinson's Improvement Programme