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Oral and Maxillofacial Surgery (Expert Forum)
Nerve damage after wisdom tooth extraction
Answered by
Michael H Kirsch, DDS - Oral Surgery, Maxillofacial, Wisdom Teeth, Bone Grafting, dental implants
Dr. Michael H. Kirsch
Caldwell - NJ
Questions in the Oral and Maxillofacial Surgery forum are answered by Dr. Michael H Kirsch and Dr.
Mario Tuchman. Topics covered include teeth extractions, wisdom teeth, dental implants, bone grafting, orthognathic surgery, facial bones realignment, facial trauma repair, jaw alignment, anesthesia , jaw cyst or tumor diagnosis, reconstructive jaw surgery, temporomandibular joint syndrome (TMJ) and TMJ surgery.
Nerve damage after wisdom tooth extraction
by FinMF, Mar 10, 2009 03:32PM
On 18th Aug '08 I had 4 wisdom teeth removed under G.A. at a UK hospital. The operation took 90 mins. Over the next 7 to 10 days I had intense pain, facial swelling/bruising and most worryingly very strong numbness and pain to the left hand side/front of my tongue and under my chin.
Between Aug and Oct '08 I attended the hospital with regards to the numbness. I still had intense numbness in the left hand side of my tongue as well as under my chin. These areas however were NEVER without a loss of complete feeling so I had hope at this stage. Upon speaking to consultants I was informed if the feeling had not returned completely after 3 months it would not return to normal. Other consultants said the same thing but stated 6 months, 1 year, or even 18 months - 2 years as the "permanent injury" point. Surgery was mentioned as an option but they stated that the risk of futher injury was "high". I asked how I have the numbness and the best answers I got were the nerve was stretched during a difficult extraction. The consultants stated that it was unlikely the nerve was severed due to some feeling being in my affected areas.
In Nov '08 I got virtually complete feeling back in my chin. I have about 65% feeling in the affected areas of my tongue, although no real improvement for 2 months. Whilst I feel things on the affected area of my tongue very well I have a very odd sensation INSIDE my tongue. I realise this can't be the case but I still feel a strong numbness/discomfort/pain despite having the feeling I do. I had a consultation last week. I was told surgery was not an option due to the feeling I have. I was also infomed it was "unlikely" nearly 7 months on I would make a full recovery. I am taking no medication. I was put on nerve blocking tablets for 1-2 months however this gave me involuntary hand movements so I came off them. I still feel a great level of discomfort, pain, numbness. Can you offer any hope or advice?
Between Aug and Oct '08 I attended the hospital with regards to the numbness. I still had intense numbness in the left hand side of my tongue as well as under my chin. These areas however were NEVER without a loss of complete feeling so I had hope at this stage. Upon speaking to consultants I was informed if the feeling had not returned completely after 3 months it would not return to normal. Other consultants said the same thing but stated 6 months, 1 year, or even 18 months - 2 years as the "permanent injury" point. Surgery was mentioned as an option but they stated that the risk of futher injury was "high". I asked how I have the numbness and the best answers I got were the nerve was stretched during a difficult extraction. The consultants stated that it was unlikely the nerve was severed due to some feeling being in my affected areas.
In Nov '08 I got virtually complete feeling back in my chin. I have about 65% feeling in the affected areas of my tongue, although no real improvement for 2 months. Whilst I feel things on the affected area of my tongue very well I have a very odd sensation INSIDE my tongue. I realise this can't be the case but I still feel a strong numbness/discomfort/pain despite having the feeling I do. I had a consultation last week. I was told surgery was not an option due to the feeling I have. I was also infomed it was "unlikely" nearly 7 months on I would make a full recovery. I am taking no medication. I was put on nerve blocking tablets for 1-2 months however this gave me involuntary hand movements so I came off them. I still feel a great level of discomfort, pain, numbness. Can you offer any hope or advice?
Doctor's Answer
by Michael H Kirsch, DDS, Mar 10, 2009 04:35PM
, Mar 10, 2009 04:35PM
Unfortunately the injury may not heal completely without sugery. There are a wide variety of opinions with regard to nerve injuries, treatments and outcomes.
I would seek an opinion from a consultant who actually performs repair procedures on this nerve on a routine basis. There have been reported cases of spontaneous recovery even at 12 months post-injury.
The three month rule is currently appropriate with regard to a high percentage of cases. If you are experiencing and type of pain or discomfort then surgery may be the only viable permanent option. Chronic pain is a debilitating condition and is not tolerated as well as anesthesia.
There certainly are risks for this type of procedure and you must ultimately make the decision that is best for you. I know it's not the easiest thing to hear but it's really going to be up to you either way.
Keep us posted and best luck!
Information contained within this reply is intended solely for general educational purposes and is not intended nor implied to be a medical diagnosis or treatment recommendation. This is not a substitute for professional medical advice relative to your specific medical condition or question. Always seek the advice of your own doctor for medical condition. Only your doctor can provide specific diagnoses and therapies.
I would seek an opinion from a consultant who actually performs repair procedures on this nerve on a routine basis. There have been reported cases of spontaneous recovery even at 12 months post-injury.
The three month rule is currently appropriate with regard to a high percentage of cases. If you are experiencing and type of pain or discomfort then surgery may be the only viable permanent option. Chronic pain is a debilitating condition and is not tolerated as well as anesthesia.
There certainly are risks for this type of procedure and you must ultimately make the decision that is best for you. I know it's not the easiest thing to hear but it's really going to be up to you either way.
Keep us posted and best luck!
Information contained within this reply is intended solely for general educational purposes and is not intended nor implied to be a medical diagnosis or treatment recommendation. This is not a substitute for professional medical advice relative to your specific medical condition or question. Always seek the advice of your own doctor for medical condition. Only your doctor can provide specific diagnoses and therapies.
