I was originally on the fence about whether I needed to see an oral surgeon of it my general dentist here in Auburn should do my wisdom teeth extractions. My dentist assured me I’d do fine and said that my extractions wouldn’t be complicated—that the only reason to see the oral surgeon would be if I wanted full anesthesia. Long story short, I went ahead and had him do it last week but I’m still feeling numb on my lower right side.

When I called and told them this, they more or less dismissed me, saying this “just happens sometimes,” I signed a form saying I understood it beforehand, and to come back in two weeks to have it checked again. I’m more than a little frustrated because I’m having trouble eating and chewing because of it really bothers me that they seemed more concerned covering their backsides about the form I supposedly signed. I may have, but that’s not the point.

Is there something they or I should be doing to get me back to normal faster?

Thanks,

Ruben

 

Dear Ruben,

It sounds like you have nerve damage in your lower right jaw. This will, in all likelihood, heal on its own, but let’s dig into what happened and what your options are.

The Inferior Alveolar Nerve Runs Along the Lower Part of Your Jaw

The image here shows approximately where your jawbone nerves sit, with “B” being the aveolar nerve. Everyone is a little different, so sometimes the nerve can run much closer to the teeth or it might be distanced more. Your dentist should have taken an x-ray before the extractions before deciding how to proceed. The nerve can even been seen on traditional panoramic x-rays as a dark line. Although it’s not the same as a 3-D image, it’s generally enough for the doctor to be able to evaluate the potential for issues during the extractions.

Nerve Damage During a Wisdom Tooth Extraction Falls into Three Categories

There are multiple ways nerve can be damaged during a tooth extraction. Healing is largely dependent on the type of injury.

Bruising

Also referred to as “stretching,” bruising is generally the mildest form of nerve damage that can occur during an extraction. This might be the case if mild pressure was applied to the nerve during the extraction or if swelling put pressure on it. In these cases, the nerve will generally heal in about a month on its own unless the stretching is severe. If a patient is experiencing pain, a doctor might offer some kind of palliative treatment or medication to help with that, but there’s nothing that can be done to restore sensation.

Crushing

It takes more pressure to cause a crushing-type injury. That might happen if downward pressure is applied to the tooth during the extraction or if the tooth breaks and the dentist has to go in and remove fragments, pressing on the nerve in the process. In these cases, the nerve fibers will regrow and heal, but it can take a year or so before sensation is restored.

Severing

The same things that cause crushing injuries can also sever the nerve, as can outright trauma directly to the nerve. However, the nerve will not regrow in these cases and the injury is permanent. On the whole, though, research shows latrogenic paraesthesia (abnormal sensation following medical treatment), is only permanent 25% of the time. And, even then, there are potential treatments such as nerve grafts that may help. Prognosis is best when surgery happens within three months of injury, but people have success much further out too. Many people simply adapt to the situation as well.

Sit Tight and Do Some Soul Searching

Chances are, you’re dealing with bruising. In which case, there may have been nothing the dentist could do to prevent it. The latter two are questionable—dentists are taught techniques to avoid damaging the nerve and many never see a single case of permanent damage their entire careers, but that doesn’t necessarily mean there weren’t extenuating circumstances either.

The main point is that you feel they dismissed your concerns. Their offering you an appointment in two weeks might be them trying to set you at ease though. It’s unlikely anything will be different in two weeks. Again, no change is likely to happen for three more weeks. So, give this some time and see what happens at your next visit and when you hit the month-mark. If you feel they’re still being dismissive, you may want to start looking around for a new Auburn dentist. And, if the numbness is still happening a month from now or you simply want more assurance, you may want to visit an oral surgeon for evaluation. Best of luck to you.

 

This blog is sponsored by Dr. Raymond Bolt, an Auburn, AL dentist specializing in comprehensive family care.