My first attack was in August. I discovered after many dental visits that a cracked molar damaged my trigeminal nerve. Tooth pulled, pain subsided and I thought maybe that would be my one and only attack. Eight months later, my ear on the tn side (right) started hurting. It felt like an ear ache. My GP told me there is no sign of an ear infection. He referred me to a neuro. Today it hurts worse. The pain radiates to back of head, halfway down top of jaw and near eye. Last time the pain was on lower jaw to middle of mouth, and upper jaw to nose. I had Bells Palsy on the same side ten years ago and I have a degenerative cervical spine. Wondering if there is a relation between these problems and why tn pain is different from last time. Also, should I take tegretol now? Or wait till pain gets worse? It’s about a 6 now but high pitched sounds give me zaps of intense pain. I hate the drugs.
Regarding your question about Tegretol. Tegretol and all of the "anti-seizure" medications are meant to be taken on a daily basis. It takes time for it to build up an effective level, taking it at the time of pain only does not give it time to be effective. Also periodically you should have your blood level checked to make sure your dosage is in a therapeutic range. Give the Tegretol time to build up and for your body to get accustom to it and the side-effects won't seem as severe.
hi Debbie - i also had tn pain, triggered by dental work, into my teeth and molars last year ... it went away with meds (gabapentin and amitriptyline) and i was pain free for 2 months. Now it is back but very different. like you i have horrible ear pain and pressure and numbness and tingling in my lower jaw ( last time it was all upper ) anyways i have started back on both meds x 5 days now. I should have started 2 weeks ago but was in denial and hoping it was something else. Now i am still waiting for relief . i think you should start those meds right away before the pain wears you down to the ground. Take care and let me know what helps for the ear pain.
I agree. Take them. Last time I had ATM, a 100 mg.tegretol would work just pop it in and chew it.
In my experience--take them Debbie. The pain could very well get worse. I have decreased and increased a few times and the pain won't likely just go on its own.
I have ear pain and teeth pain as well. The pain I have now is way more wide spread than it was when all of this started.
Thank you for your responses. I just now read them. Today the pain did wear me out. It’s not as bad as last time, which was easily a 10, but I would say still a 6 but with short zaps of pain from high pitched noises or if I bump my ear slightly. I will start the tegretol tonight and call Neuro and ENT (still hoping it’s an ear infection that the GP overlooked) tomorrow. 
no time for this.
Last time the tegretol worked quickly after the Neuro shot me up with nerve blocks. He said if it works it indicates it is, indeed, Tn.