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Dental Nerve Injuries
Although uncommon, injury to the mandibular (lower jaw) nerve may result in anesthesia (numbness), paresthesia (tingling), dysesthesia (pain and burning), or a combination of these symptoms on one side of the face. If the entire nerve is affected, the symptoms may mimic the effects of partial or complete numbness following a dental injection of local anesthetic, including the tongue and lower lip. The condition is sometimes confined only to the lingual nerve, the branch of the mandibular nerve that provides sensation to the tongue.
In most cases, there is a gradual regeneration of sensation (several weeks or even months), or the condition may be long term. Healing of nerve injuries is commonly slow, with a reduction in the intensity of the sensations and the size of the area affected. Care must be taken to avoid inadvertent lip or tongue biting during eating.
Dental nerve injuries are usually the result of trauma, although infections and neoplasms (tumors) may be implicated. External traumatic injuries, unless severe, do not commonly cause dental nerve damage due to the thick, dense protection of the lower jaw bone. The most common cause of nerve injury occurs after a mandibular (lower) dental nerve block injection. During routine injections, the needle may touch, or pass through, the targeted nerve, but rarely causes harm. In select instances, even this relatively minor trauma may result in damage. Numbness from a dental injection is usually transient. This bizarre occurrence is not commonly associated with improper technique or operator negligence.
Complications of tooth extraction of third molars (wisdom teeth) are more commonly associated with dental nerve injuries, particular long term symptoms. Although unusual, the occurrence should be considered as a possible removal of wisdom teeth when the risks and benefits are weighed.
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