Neuralgia of Dental Origin*

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Many methods have been advocated down through the years for the relief of pain in the head but less consideration has been given to the etiologic factors involved. Trephined skulls of ancient people have been uncovered and it has been assumed that operations were performed to allow confined demons to escape. Drugs also were used for the relief of headaches, and, in the Ebers Papyrus, frankincense, cumin, and goose grease are mentioned as specific remedies. These empirical methods, however, were gradually replaced when rational and scientific thinking directed efforts toward elimination of the causative factors. During this period, the teeth assumed increased importance in regard to etiologic factors; indeed, at times, they were given a place of too great prominence. The studies in 1829 of Sir Charles Bell were of great importance and to him we are indebted for an understanding of some forms of pain in the head, particularly of facial neuralgia which is due to disorders of the fifth rather than of the seventh nerve as was previously thought.

The anatomical relationships of the fifth nerve, which is the largest of the cranial nerves, are interesting in relation to the problem of pain in the head. This is the great sensory nerve of the head and face and the motor nerve of the muscles of mastication. The trigeminal nerve emerges from the lateral aspect of the pons, near its upper border and courses forward to the apex of the petrous portion of the temporal bone where it forms. . .



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