I have trigeminal neuralgia and need my wisdom tooth removed should the dentist handle my extraction differently?

No. Depends : It depends if the extractions are for impacted wisdom teeth or not. It also depends if an oral surgeon or general dentist is doing the extractions. It also depends if he knows what he is doing.

Trigeminal Neuralgia: Trigeminal neuralgia can be exacerbated by dental work. Unfortunately no preventive measures are available except to make sure medication is taken as scheduled to prevent a decrease in serum levels and subsequent pain fluctuations.

Preemptive analgesia: Although dental surgery is not likely to precipitate TN pain in patients who are in remission, there is always a chance that the TN may return. Therefore, preemptive analgesia with AEDs is always recommended.