Possible nerve damage

[KevinEC]

Doctors, your advice would be very much appreciated.  Several weeks ago, I went in to see my dentist for a new crown.  After the first injection of anesthetic didn't take,  he injected me with another.   In the process, a shooting electric like shock went through my lower jaw.  He explained this was because he had hit the nerve but it would be alright.  Since then, I have been back to him complaining of pain in my teeth along my lower jaw.  The only relief I get is from ibuprofen.  I did not have this pain prior to seeing him.  What advice could you give me?  Might this be the result of nerve damage?  Does this subside over time?

Thank you,

Kevin

[Jerome Tsang, DDS]

Yes, its possible that its nerve damage although the more common symptom is just generalized numbness in the area down to the lower lip.  It may takes up to several months to heal although I would imagine it would be sooner than that.

It may be possible that its due to the crown and not the nerve itself.  Has the pain started since the day of the injection or since the placement of the new crown?

[KevinEC]

Dear Dr. Tsang,

Thank you for responding.  The pain is a dull ache in the jaw area which comes and goes depending on time of day, activity level and whether I've taken ibuprofen.  The pain started after the injection wore off and I have not had the permanent crown place yet, just the temp.   Is it standard procedure to inject directly into the nerve?

Thank you

[Jerome Tsang, DDS]

No. It is rather an unintentional result from giving a dental anesthetic injection.  When giving what we call a mandibular block or inferior alveolar nerve block injection, we are aiming for a nerve on the inside of the cheek to completely numb the whole nerve.  The nerve goes down along the inside of the cheek and goes into the jawbone and provides nerve sensation for the teeth and lip.  It also splits up before that to numb the tongue.  If we inject into the area near the tooth, it won't get numb cause the nerve is in the jawbone so we try to "numb" it before it goes into the jaw, which is at the cheek area.  Since we can't see your nerve, we inject into that area and push the anesthetic into the area and numb it.  On rare ocassions, it does hit the nerve.  I've done it twice I think the last few years so it does happen.  But I haven't had any complications past the "electrical shock pain" and numbness for a day or two.  I would recommend taking the ibuprofen for the pain (as it helps with the inflammation) and monitor the nerve.  It should gradually heal on its own but you just have to be patient and give it time.  

You may want to call your doctor to also discuss the specifics of your case and if he may want to refer you to a specialist for further evaluation.

[Jerome Tsang, DDS]

Also, it may be possible that its just the temp crown that is causing an irritation.  Sorry, I didn't mean to make it sound like you definitely had nerve damage.

[KevinEC]

Thank you again for the follow up info.  My hope is that it will subside over time.  

Mt Best Regards,

Kevin