Injury due to Surgery                     



Mechanisms of Injury

Treatment options

Anesthetic options for Dentistry

Discussion Board



Patient Advocacy in Dentistry





Surgical procedures in the area of the lingual are the most common cause of nerve damage, resulting in temporary or permanent loss of sensation or pain in the distribution of the nerve.   Sometimes the inferior alveolar nerve is injured, and sometimes the lingual nerve.   Both can be bothersome injuries, but in general the inferior alveolar nerve injuries (mucosa and lip numbness) are tolerated better than the lingual nerve injuries (tongue and inner gingival mucosa).  

It is easy to search the medical literature using public services such as Pub Med and find numerous articles on lingual nerve damage from third molar removal.  Other surgeries of the jaw can have similar results if they involve the same area.  

The course of the lingual nerve can be seen in the following illustrations:

Figure1      Figure2    Figure3

Following damage, the result can be total loss of sensation, change of sensation, continual or constant pain, or a combination of these.  Some of these symptoms can be relieved by surgical intervention, as discussed in the treatment options.  

As a rough guide, if your surgeon/dentist identified during the procedure that the nerve was severed, you should have been referred immediately for surgical repair.   If it becomes evident after the anesthesia wears off that you have sustained nerve injury and it does improve within 6-8 weeks, it may be appropriate to see a board certified surgeon, with expertise in nerve repair.   In the USA - to verify board certification for non-dental specialties, you can check status at the American Board of Medical Specialties or for oral surgeons you have to call the phone number at the following site to check board status - American Board of Oral and Maxillofacial Surgery.  For most of the injuries that are discussed on this web site, the oral surgeons do the repairs.  The odds and completeness of recovery depend on the injury and the patient including age etc.  Surgical repairs done within the right time frame (10-12 weeks) can be expected to attain about 75% of normal sensation in about 70% of the cases.   The longer delay until surgery, the lesser the percentage of success such that it is rarely recommended after 9 months.  With partial numbness it can be hard to make the decision, which should probably be made within 4-5 months.  

Both the inferior alveolar nerve and the lingual nerve can be repaired, including the portion of the inferior alveolar nerve that travels within the bone.  The rates of recovery of the inferior alveolar nerve is better than those with the lingual nerve. 

I am still in the process of gathering more information on this topic, and would welcome any additional information or insight that anyone has, just email me at the link below (webmaster), or add your comments to the Discussion Board.