Lingual Nerve Injury??

Hi Doc,
          Three weeks ago I had a two crown procedures done in one sitting on #30 and #31.  #30 was close to the nerve and was originally going to be a root canal, but he was able to avoid exposing the nerve.  My dentist had new technology that allowed for a fitting and permanent crown in the same visit (i.e. no temporary crown was needed).  After the procedure and for the last three weeks counting, i've been in chronic pain both in #30 tooth and my jaw.  Occasionally when the pain is at its worst, it can shoot up into my ear, and even extend to the same side of my tongue.  This phenomena led me to question whether the lingual nerve had been injured.  My dentist seems to think the same, although i don't have any paresthesia or burning sensations that frequently accompany nerve hits; only pain.  My question for you is, in your opinion, does this sound like lingual nerve damage?  
  My dentist also has re-examined me and doesn't see any sign of infection, though he does suggest that if the pain continues, a root canal may need to be done.  I would be apprehensive however if there was nerve damage to risk further injury from injection needles.  I know its a long post, but your opinion would be greatly appreciated.  Thanks so much!

[Jerome Tsang, DDS]

I agree with you and your dentist's assessment that its not likely a nerve injury from an injection.  It sounds to me that you may need a root canal done on the tooth.  The pain from the tooth can radiate from the tooth to other areas of your mouth, termed referred pain.  Have they tried adjusting the bite or cleaning the area out for any possible excess cement?

[sean111137]

Yes, i went back to my dentist two weeks ago and he cleaned out a little bit of excess cement.  He checked the bite and said that looked perfect and wasn't an issue.  Thanks for your input, Doc, I appreciate it!  I may just give it another week to see if there's any improvement, and if not, continue on to complete the root canal.  Thanks again, best wishes.

[Jerome Tsang, DDS]

The root canal should fix the problem.  That would be my next logical step too.

[Sue549]

Almost 3 weeks ago now I went to the dentist to have a tooth filled. When the dentist went to numb me I got like a terrible shock in my tonue. The numbness is still partially there, the side of my tongue is like it is rubbing on a sharp piece of something, it feels even worse as the day goes on. They say it will go away. Now they are suggesting laser treatment. Is this a good idea? Will it go away? Please help me I don't want it to get worse.

[Jerome Tsang, DDS]

Laser treatment for the injured nerve?  I haven't heard of that before.  

As for the nerve injury, it will take some time for it to heal.  Usually a needle stick of the nerve will heal on its own.  It may take literally up to 6 months to completely heal and it doesn't by that time, it probably won't ever.  But I would think it would a more extreme situation such as damage to the nerve when trying to get out a hard buried wisdom tooth.  

As for the sharpness, is it like a prickly feeling or is there something sharp from the filling?

[Sue549]

They say there is nothing there that is sharp left over from the filling. At times it feels like the side of my tongue is raw and other times it is a burning feeling.My cheek is also numb to a point.It is from the tip of my tongue to the back on only the one side. I feel like I have to leave my teeth apart as though I just had a procedure done.

[martie52]

I just got back from the dentist. I had three shots to numb my lower jaw. The third shot caused a "shock" in my tongue. The dentist said that it was a good sign and meant he the numbing agent where he wanted it. Now that I'm reading all of this about nerve damage I'm really worried. I'm still numb so I don't know how my tongue feels. Did my dentist make an error? Should I be concerned?? I never felt a shock like that before.

[Jerome Tsang, DDS]

Sorry I must've missed your post.  It sounds like there may have been a nerve injury possibly from an injection.  Give it some time and it should resolve on its own.  It may take up to 6 months but it should gradually improve.

[Jerome Tsang, DDS]

Your situation is similar.  The injection probably hit the nerve directly, causing the shock pain.  There may possibly be some remaining numbness or tingling when the anesthesia wears off.  It could take some time to heal.  There is also the possibility that there won't be any problems at all.

[Sue549]

It has been 5 weeks now and my tongue and cheek are still partially numb. I have pain in my tongue and jaw. Is there anything that can be done? Do I need to see a specialist ? If I talk or eat it causes this to feel even worse.

[Jerome Tsang, DDS]

You can ask your dentist for a referral to an oral surgeon or you can go see a neurologist possibly.  You may need a referral from your primary MD depending on your insurance.