Injury to the peripheral sensory branches of the trigeminal nerve (nerves that provide feeling to the face and oral structures) are known to cause complications in dental and oral and maxillofacial surgical procedures, including third molar (wisdom teeth) removal, endodontic (root canal) procedures, dental implant placement, facial trauma, and other oral and facial procedures. Nerve injuries are an inherent risk of any surgical or dental procedure and may occur despite the best of care provided.
The most commonly injured nerves are as follows:
- Lingual Nerve injury (usually a numb tongue)
- Inferior Alveolar Nerve injury (usually a numb lip/chin and gums)
The patient with a nerve injury may experience a variety of sensations, such as numbness, tingling, burning, crawling sensations, electric shocks, or hypersensitivity of the affected area. These sensations may interfere with normal chewing, drinking of liquids, speaking, eating, shaving, or kissing, and they are distressing to the patient. Such symptoms, if persistent beyond several months following the initial injury, may indicate a nerve injury that will not resolve on its own and should be evaluated further.
Initial treatment of trigeminal nerve injuries involves close monitoring of symptoms and neurosensory testing. The optimal window of opportunity to surgically repair a trigeminal nerve injury with the highest rate of success is three months after the initial injury. Specialized microsurgical techniques have been developed to improve the environment in which the nerve endings heal, providing a better chance for recovery of sensation. The goal is to be able to identify issues early on, taking care of those injuries that will not spontaneously resolve or prevent irreversible damage.
Fortunately, most nerve injuries have been shown to improve either partially or completely without surgical intervention. Once your examination is complete, your surgeon will discuss with the type of nerve injury you have, the possible operation, other methods of treatment to correct it, and the outlook for improvement of sensation.