The suffering that comes from a tooth extraction can turn into agony if a nerve is very close to the tooth being pulled. Sometimes a nerve becomes damaged and the patient feels prolonged pain, numbness and tingling that can go on for several days. Paresthesia can also cause tongue paralysis and changes in taste and temperature sensations in the mouth. The suffering caused from nerve trauma is called paresthesia. Paresthesia is most likely to occur with the extraction of the lower third molars, which are commonly called the wisdom teeth.
There are risks for any type of surgery, including oral or dental surgery. Regardless of the skill of the dentist or oral surgeon, the patient can experience paresthesia. The injection of Novacaine that is administered to numb the gums and mouth can affect the nerves for a prolonged period of time. If a nerve is too close to a tooth being extracted, the nerve can be damaged. If there is damage or injury to the nerves, the patient may feel sharp pain, burning pain, partial or total loss of sensation in the mouth, jaw and lips.
What nerves are most affected by paresthesia?
The nerves that serve the wisdom teeth are the most vulnerable to nerve damage. These nerves are the mandibular and lingual nerves. The mandibular nerve runs along the roots of the teeth of the lower jaw on both sides and then branches out to the lip and chin. The lingual nerve branches out from the mandibular nerve and serves the tongue and part of the lower jaw. When these nerves are numbed with Novacaine you feel numb in these areas.
Paresthesia can be identified once the effects of the anesthesia wear off. Most of the pain and burning will wear off within hours or days of having a tooth extraction or other type of oral surgery. If the oral surgeon observes that a nerve has been severed, he/she will repair it immediately. In rare cases, however, a neurosurgeon may have to be consulted.
If you have oral paresthesia, it will not interfere with the movement of your facial muscles. Usually paresthesia resolves without medical or surgical intervention; the pain will diminish and normal sensation will return in a few hours or a few days. If oral paresthesia continues past a few days, you should see your oral surgeon. If corrective surgery is performed within the first few weeks, the repair should be successful. However, if the paresthesia goes untreated for several weeks the nerve may not be able to be reconstructed.
Most of us are happy with our dentists and oral surgeons, because we have not experienced any problems. There is always a chance that problems could occur, regardless of the dental surgeon’s experience. However, the dentist or oral surgeon’s experience and techniques can influence your experience. If the dentist or oral surgeon you go to is in a hurry or is careless in his/her techniques, you could wind up with paresthesia.
If you don’t already have a dentist or oral surgeon that you are happy with, ask your friends who they go to. Your friends and neighbors are the best advertisement for good dentists and oral surgeons. They are also the most likely to be honest with you about any bad experiences they have had with a dentist or oral surgeon.
Follow-up appointments are very important when you have a tooth extraction or have some kind of oral surgery. The loss of sensation and pain should wear off and you should be much better on your follow-up appointment. However, if you are still having pain, burning, and numbness, your oral surgeon will need to test your nerve responses and make corrective measures to repair the involved nerve to prevent permanent loss of sensation.
Madison Dental Family Dentistry