Oral and Maxillofacial Surgery Expert Forum
Numbness and Pain after Apical Surgery
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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.

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Numbness and Pain after Apical Surgery

I had apical surgery on my lower right molar one tooth in from the back about 10 days ago. This was to correct what was apparently a failed root canal a year earlier. The procedure was performed by an endodontist that specializes in this work. I know there were issues with getting the bleeding to stop during the procedure but they finally did and proceeded with the work. There was not a lot of pain or swelling after the surgery however several days later the eye tooth and the incisor next to it 4 teeth away from the molar that was worked on started hurting. The pain feels as if I forced a credit card between the two teeth. The stitches for the apical work were on the other side of the eye tooth and ran toward the back where he did drilled through the bone. The pain has now been going on for almost a week even though the rest of the area seems to be healing. There is a sensation of slight to moderate numbness in the teeth immediately surrounding the eye tooth along with the above described pain. I was surprised when I saw that the stitching was so far away from the area of work and that so much of the gum was moved out of the way for the surgery. I'm concerned that nerves were damaged during the procedure. I've heard of people who have had permanent nerve damage and am concerned that this may not go away. 600mg of Ibuprophen doesn't have much effect on the pain. I do take one vicaden at night which does seem to work well but how long can keep taking this.
Tags: apical, Pain
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Nerve damage following apicoectomy surgery is rare these days owing to the fact that dental implants have such a high success rate.  Meaning, many Oral and Maxillofacial Surgeons would advise against having the apicoectomy procedure if they thought the mandibular nerve would be at an unacceptable risk.  The removal of the failed root canal tooth and dental implant replacement is better option in those cases.

Inflammation and swelling around the nerve can lead to similiar symptoms.  This condition would be temporary and gradually resolve as the swelling diminishes.

Your continual and severe pain is not common following the standard procedure you have described.  Surgical complications should be managed by a surgeon who performs these procedures on a daily basis.  If your dentist does apicoectomy and jaw surgeries everyday then they should be able to manage your condition.

If your dentist only does these procedures occasionally then you should seek a consultation with a Board Certified Oral and Maxillofacial Surgeon as soon as possible.

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.
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Michael H Kirsch, DDSBlank
Dr. Michael H. Kirsch
Caldwell, NJ
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