Trigeminal Nerve

Trigeminal Nerve

Trigeminal Nerve

Trigeminal Nerve:

The trigeminal nerve is the fifth cranial nerve.  It is composed of three branches on each side of the head (hence “tri” and “gemini”).  It has the largest number of sensory neurons of any nerve in the body (100 times more dense than any other nerve) and is represented on the brain sensory cortex by 28% of the surface area. The trigeminal nerve has three sensory nuclei that it sends information to in the brain, and one motor nucleus.  One of the nuclei, for proprioception, is composed of the only sensory cell bodies in the brain.  This is a very important aspect of the trigeminal nerve and accounts for much of why it has a major influence on brain function and health in general.

The fact that the trigeminal nerve has such a high density of pain fibers also makes it very special and influential on homeostasis (body health).  With bite disturbances, the trigeminal becomes activated leading to the release of pain neuropeptides (substance P and calcitonin gene related peptide).  Substance P is known to regulate many body functions, hence alteration in its normal level leads to a wide spectrum of medical disorders (Associated Medical Disorders). Elevated substance P has two primary effects on the body:1) hyper sensitizes all sensory neurons 2) primary mediator of inflammation. With hyper sensitization, the body over reacts to sensory input causing frequent illness.  With increased inflammation, many neurogenic inflammatory disorders typically develop (cardiac disease, arthritis, IBS, migraine, skin disorders, seizures, auto immune disorders, etc.).

Correction of trigeminal nerve disturbances most often involves jaw alignment (TMJ treatment), but can also involve abscessing teeth, failed root canals, cavitations (osteonecrosis), broken jaws, etc. Jaw alignment is done with removable appliances with multiple adjustments (it is a process and not a procedure). An  extreme case of trigeminal disturbance would be trigeminal neuralgia: typically treated improperly with surgery and not jaw alignment.

8 Responses to Trigeminal Nerve

  1. lana sclafani says:

    I was diagnosed with trigeminal neuralgia in Oregon by an oral surgeon four years ago.

    I’ve had gamma knife surgery which was partially successful in that I no longer have periods of pain lasting more than one hour, but I continue to have periods of pain up to 50 or more a day. Sometimes no pain for weeks or months at a time; then BANG, it’s back.

    I’m scheduled for MVD surgery now; and hoping it works for the long term. They say the mylar sheath is worn off the nerve.

    I just learned about you. Any recommendations? I live in Hawaii.


    • Dr. Jennings says:

      Lana:I would try a very simple 2 mm soft splint to be worn 24 hours per day for starters and postpone the surgery. I have been very successful at treating TN through bite changes. Dr. J

  2. amit alok says:

    Why soft splint here when naturally the bite is hard ? thanks

    • Dr. Jennings says:

      Amit: It is much harder to get bite physiologically acceptable with a soft splint than a hard one. I recommended a soft splint as an inexpensive diagnostic appoach. If it doesn’t work then I would recommend a hard splint that precisely positions the jaw in the ideal orthopedic trajectory. DR. J

      • Dhezy says:

        TMJ cures/treatments?i have been diagnosed with TMJ and am wriedonng if any body has any cures or treatments that have worked for them apart from surgery. If anyone has any info please help ASAPthanks

        • Dr. Jennings says:

          I have a very high degree of success in treating TMJ with my non-surgical anterior reposition therapy. It involves repositioning the lower jaw more forward to decompress the TMJ. It is done with removable appliances over about a 2 year period of time. You are correct in wanting to avoid surgery as it does not correct the primary problem in most cases which is back teeth being too short allowing the jaw to go up into the TMJ joint too far.Dr. J

  3. Bikal Gurung says:

    Does TMJ disorder cause Trigeminal Neuralgia?

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