I have a patient requiring some dental work who say she has trigeminal neuralgia. She is being managed by a neurologist. She decribes the episodes of pain as paroxysmally. She describe the pain sensation as a trigger area on the face, so sensitive that touching or even air currents can trigger an episode of pain. It affects her lifestyle as it can be triggered by common activities in her daily life, such as eating, talking, putting on makeup and toothbrushing. The attacks she decribes feel like stabbing electric shocks, burning, pressing, crushing or shooting pain that becomes intractable. The attacks affect one side of the face at a time, last several seconds, hours or longer, and repeat up to hundreds of times throughout the day. The pain also tends to occur in cycles. She is on tegretol. Im hesitant to work on her because I am afraid I will flare up the pain and make things worse. Any throughts on how to approach this?