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Patients often ask us about potential nerve damage from getting their wisdom teeth extracted. What exactly do they mean by this? You may know someone who had their wisdom teeth extracted and lost sensation on part of their lip or chin. The reason why that might happen is that the inferior alveolar nerve was interfered with during the procedure. The inferior alveolar nerve is the nerve that lies on each side of the jaw and it innervates your teeth and the soft tissues around the lip on each side of the jaw. There are two sides to the inferior alveolar nerve and they innervate each side of one’s mouth.
My fiancé had her wisdom teeth extracted when she was 29 years old by a surgeon in Toronto and she was not able to feel part of her lip and chin for about six months after the procedure. The inferior alveolar nerve is a sensory nerve that provides the sensation of feeling. It is not a motor nerve so it does not affect movement of your lip or chin. It’s a major nerve to look out for whenever performing a wisdom tooth extraction.
You may be wondering how a surgeon can plan for potential interference of the inferior alveolar nerve. The most useful tool to use is 3D technology. A traditional panoramic (2D) x-ray is helpful during a consultation to show the patient whether their wisdom teeth are impacted and also depicts the angulation of the teeth, however it has its limitations when creating a surgical plan. It does not allow us to plan for potential risk factors such as the likelihood of hitting the inferior alveolar nerve. Every patient has unique anatomy and where the inverior alveolar nerve is in relationship to the wisdom teeth will vary. 3D technology such as a cone-beam CT scan, has an added dimension of depth to show the surgeon where this inferior alveolar nerve lies and how the surgery can be planned around this. When scheduling your appointment, it is highly important to select a surgical specialist who utilizes 3D technology versus the traditional 2D panoramic x-ray which is what the majority of dental offices use. With the added dimension of depth, particularly the sagittal view, the inferior alveolar nerve and where the wisdom teeth are in relationship to that can clearly be seen and the surgeon can avoid any potential damage.
A properly trained surgeon with the right technology is key to avoiding nerve damage
Despite the risk of damage to the inferior alveolar nerve and the resulting loss of sensation, the good news is that in most cases the loss of sensation is temporary and will go away over time. This is not always the case, but in most cases patients usually say that the feeling of sensation comes back.
I recently met the mother of one of my patients at a consultation. She had brought her teenage daughter to have her wisdom teeth extracted. The patient’s mother was in her mid to late 30s and she mentioned to me that approximately a year ago, she had her wisdom teeth extracted at another surgical center due to pain related to one of the wisdom teeth. The surgeon recommended that she remove all four of her wisdom teeth. She followed his advice and she ended up suffering nerve damage on the side that was not bothering her. Her inferior alveolar nerve was damaged during the surgical procedure. She had numbness in her lip and chin area and it was really disturbing for her. Her chief complaint was that when applying makeup she could not feel what she was doing in the lip and chin area. I specifically asked her whether or not her surgeon used 3D technology. I showed her the difference between the panoramic x-ray and the CBCT and she recalled only the 2D x-ray being utilized. She told me that he had never expressed to her anything about this technology to basically see what was going on and the risk factors. She was a little upset about the experience she had at that office which is why she sought a consultation at North Texas Dental Surgery.
One final way the inferior alveolar nerve can lose sensation is when the surgeon is numbing the patient. This is extremely rare, but when approaching the area where patients need to be numbed, the needle and the anesthetic may be too close to the nerve. There is no way to prevent this from happening, it is just dumb luck. This can case a patient to feel paresthesia in the lip. It is a very very minute percentage of cases, but it is a possibility. These cases tend to resolve over time.
To summarize, if you have had your wisdom teeth extracted and you have this sensation of numbness in your lip and/or chin area, there is a good chance that something happened with your inferior alveolar nerve.
In summary, to avoid nerve damage numbness:
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