Dental and Oral Surgery Nerve Injuries - Dr. Ducic, MD - Washington Nerve Institute
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Dental and Oral Surgery Nerve Injuries

Tongue or Lower Lip/Chin Pain, Numbness or Parestehsia Following Wisdom Tooth Extraction, Root Canal or Dental Implant Surgeries

 

Every day many patients undergo dental and oral surgery procedures, including:

 

  • Wisdom tooth extraction
  • Root canal procedures
  • Dental implant surgery

 

Respective oral surgeons, endodontists, and dentists, doing their best to address oral cavity or dental issues, successfully treat most patients. Unfortunately some patients end up with unfavorable outcomes, related to variations in anatomy, required dissection, local anesthetics injection injuries, root canal fillers, or even unknown reasons. Clinically, patients report having undergone any of the aforementioned procedures, and then develop either acutely or gradually some or combination of any of these symptoms, usually involving one side of the lip, chin or tongue:

 

  • Lower lip numbness
  • Chin numbness
  • Tongue numbness
  • Pins/needles, burning sensation
  • Pain, jaw pain, headache

 

Nerves involved mostly include:

 

  • Inferior Alveolar Nerve (innervating lower lip, chin)
  • Lingual Nerve (providing sensory innervation to the tongue)

 

It is important that patient’s surgeon performing any of the above procedures ensures no common dental or oral pathologies are responsible for the onset of patient’s new symptoms. Once done, each patient’s management may vary depending on the clinical scenario and procedure being performed. Thus the patient with contrast within IAN canal following root canal might require whole different treatment approach when compared to patients following dental implant or wisdom tooth exaction. For those with more chronic symptoms/pain, present for more then 4-6 weeks after initial surgery, and in the absence of oral cavity or other dental pathologies, evaluation by a peripheral nerve surgery expert should take place. Thus, it is important that the referral and the communication between primary surgeon and expert in nerve surgery is conducted in a timely manner.

Surgical Treatment of Patients with Tongue or Lower Lip/Chin Pain, Numbness or Parestehsia Following Wisdom Tooth Extraction, Root Canal or Dental Implant Surgeries

Unlike medical management which is focused on treating symptoms, peripheral nerve surgery treats the cause of the pain (stump neuroma, damaged peripheral nerve with previous surgery). The involved nerve and its neuroma are surgically removed. Considering these nerves control only sensation, there is no motor deficit of any kind following this procedure. Certainly, this all is done after an initial work-up by your neurologist excluding recurrence of acoustic neuroma or other pathology.

 

During Surgery for Chronic Lip/Chin/Tongue Numbness or Pain Following Dental or Oral Procedures

 

  • You receive general anesthesia so you won’t feel any pain during the surgery.
  • An intraoral incision is preferred and made over the involved nerve (Inferior Alveolar Nerve requires also bony mandibular opening, while Lingual Nerve is accessed via modified floor of the moth/gingival approach). Damaged nerves are removed and the microsurgical reconstruction of involve nerve is done with the most current microsurgical technologies available. Intraoral mucosa is then closed in anatomical layers.
  • This surgery is an outpatient procedure; although depending on the case specifications might require an overnight stay. Sutures are removed in average three weeks later.

 

If you are not sure about your eligibility for surgery, and if you are not in the Washington, D.C. area, you can send me your records so I can determine if you are a good candidate for treatment. Visit my patient forms page for a downloadable form.