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Jacob O. Layer DMD, PC March 2018 Newsletter
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Trigeminal Neuralgia
As requested, we are doing a follow-up to our article last month about facial pain – specifically Trigeminal Neuralgia.

The trigeminal nerve is one of the main nerve branches in the face. It’s the 5th cranial nerve and the most widely distributed one in the head. Trigeminal Neuralgia (or TN) is when chronic pain develops in association with the trigeminal nerve. There are two types of TN. TN1 is sporadic, sudden, extreme shock or burn – like feeling of pain that lasts usually under 2 minutes. TN2 is constant aching, burning, or shooting pain that is typically a little duller than TN1. Some people can have both types at the same time (bilateral TN), but TN1 is the most prevalent. TN usually affects only one side of the face and is most common in women over 50.

TN can result from various conditions, the most common being a blood vessel that presses on the trigeminal nerve as it exits the brain stem. This pressure starts to wear away the protective covering (myelin sheath) of the nerve - triggering pain signals to the brain.
Treatment options for TN are subpar at best (in my option). Almost all surgical treatment options have a best outcome of 1-3 years of relief for type 1 TN (some even resulting with permanent numbness in various areas of the face). The most invasive treatment is called Microvascular decompression (MVD). This treatment involves creating a small hole in the mastoid bone behind the ear and, through it, the surgeon places a “cushion” between the nerve and the compressing blood vessel. This procedure provides the longest lasting relief of about 12-15 years.

If you suffer from TN and want to avoid surgery then more than likely your doctor will want to put you on an anti-convulsive medication which dampens the pain signal to the brain. There is another non-surgical option, that needs to be studied further, but the treatment outcome seems to be very promising. That option is an acupuncture (specifically the Xiaguan ST7 point) injection of a high dose of vitamin B12. The study that was done found Vitamin B12 injections were far more effective than anti-convulsive oral medication.

It does seem very plausible that some TN could be a result of a vitamin B12 deficiency. As we know (from last month’s Vitamin B12 article) that it can take years for a B12 deficiency to show up because our bodies store so much of it. Plus, as we get older, our bodies have a hard time converting B12 into its usable form: methylcobalamin. I’m hopeful that more research is being done regarding the correlation between TN and B12 deficiency. I only found one study that was done and that was 11 years ago and in China.

I hope this article helped shed some light on trigeminal neuralgia for y’all. If you or someone you know suffers from TN, have them get their vitamin B12 levels checked. It’s not going to hurt anything and may get them on a path to finally being pain free.

- Jocelyn RDH

Folate (Vitamin B9)
Folate is another important B Vitamin. It’s a key ingredient to making serotonin and melatonin in the brain, DNA synthesis, and in the metabolism of proteins.

Adult men and women need 400mcg of folate every day (pregnant women need 600mcg). Because we fortify grains in the US, most people obtain adequate amounts of folate from food. However, with the rise in gluten allergies and with many people eating organic foods, more and more people need to take a folate supplement. A Folate deficiency can sometimes be seen in the mouth by a sore tongue with shallow ulcers on it.

When looking for a supplement, be sure to get one that is the active form of folate: L-methyl folate. It’s estimated that at least 10% of the population can’t convert folate to its active form which means their body is not utilizing and absorbing it.

Studies have shown that adequate levels of folate are key in preventing depression - especially in women. Studies also show that maintaining levels between 400 and 600mcg can help prevent Alzheimer’s, dementia, and some cancers. The key is maintaining levels now, when you’re healthy because once Alzheimer’s, dementia, and cancer set in, folate no longer seems to help and can actually accelerate some cancers. Males also need to be careful to not have too much folate.

If you are pregnant, have a gluten allergy, or suffer from depression you should have your folate levels checked. Men should also get their levels checked to make sure their levels aren’t too high.

Hope this was helpful! Next month we will be talking about Vitamin B6!

- Jocelyn RDH

Does Alcohol Help Rid Your Mouth of Gum Disease?
The myth that using alcohol or an alcohol-based mouthwash to rid your mouth of gum disease is just that - a myth. When you use anything with alcohol in a mouth that is struggling with gum disease, it can actually make it worse.

Alcohol dries out your mouth, which prevents your mouth from naturally washing away food particles and bacteria. This lets more bacteria grow, which can increase the severity of your gum disease. What you want to do is stick with an antibacterial or antimicrobial mouthwash and avoid alcohol as much as possible This way, the bacteria levels stay down, and your dental team can get your gum disease under control.

Dr. Jake and his Team would love to hear from you! Got a question? We can help!

Jacob O. Layer DMD, PC | www.layerdental.com | 541-734-0970
1485 East McAndrews Rd., Medford, OR 97504



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