Nerve damage during wisdom tooth extraction

Content:

1. Why does paresthesia occur after tooth extraction?
2. How it manifests itself
3. How to treat 3.1. Medicines for paresthesia 3.2. Physiotherapy 3.3. Surgical treatment of paresthesia
4. Why paresthesia needs to be treated
5. How to avoid paresthesia

Sometimes surgery to remove a molar tooth leads to complications. If after it the tongue, lip, chin become numb, taste sensations disappear, they speak of paresthesia. In most cases, this unpleasant condition goes away on its own within one to two weeks, but it happens that it is not possible to do without special treatment.

When do you need a doctor’s help and who to contact?

How long does numbness last after tooth extraction and when is it time to sound the alarm? It was already mentioned above that sensitivity should be restored a few hours after the anesthetic injection was given. But situations are different - for example, after a complex removal of the “eight”, after osteoplastic surgery or installation of an implant, etc. numbness can last 1-2 days, less often up to 5-7 or even up to 10-14 days. But, as practicing dentists note, sensitivity is restored after 2 weeks in almost all patients. If after 14 days there is no improvement, then you need to go to the doctor. To begin with, you can contact the dentist who performed the previous treatment, then you can contact a neurologist or a neurophysiologist.

Read on the topic: is it necessary to take an x-ray after a tooth has been removed?

Why does paresthesia occur after tooth extraction?

Most often, the problem arises as a result of the “eights” being pulled out.

This is explained by the peculiarities of their location and non-standard direction of growth. The roots of the wisdom teeth go close to the nerve, so during the operation the doctor may inadvertently damage the latter.

Among the reasons for the development of paresthesia after wisdom tooth removal:

• The abnormal location of the unit, the presence of too long and curved roots - when extracting it, it is easy to touch a nearby nerve.
• The opening of severe bleeding after surgery, the appearance of pronounced swelling in the wound area. Because of this, the nerve endings are compressed, do not receive the nutrition they need and begin to work incorrectly.
• Careless actions of the doctor when administering an anesthetic - the needle can damage the lower alveolar process or lingual nerve. Then the tongue, lip and chin become immune to external mechanical influences.

There are factors that increase the likelihood of paresthesia occurring after dental surgery. These include:

• age over 25 years;

• the presence of acute or chronic diseases of internal organs;
• neuralgia;
• history of nerve ending injuries;
• degenerative disorders in intervertebral discs;
• CVS pathologies;
• diabetes;
• pathologies of the endocrine system;
• oncology;
• problems with the gastrointestinal tract;
• deficiency of vitamins and minerals;
• decreased immune defense.

In all these cases, the likelihood of paresthesia increases, so the doctor and patient must exercise special caution and pay due attention to preparatory measures and diagnosis.

Why does numbness occur?

The reasons for tissue numbness after removal are as follows:

• compression or squeezing of the nerve from swelling (normal manifestation): during the operation, especially if it is a complex removal of a wisdom tooth, for example, the surrounding tissues are quite seriously injured. After, i.e. within 2-3 days, lymph accumulates around this area (the main component of edema), which puts a little pressure on the nerve, causing numbness,
• Nerve damage (pathological manifestation, neuropathy): the nerve trunk can be touched or pierced by a syringe needle. It can also become damaged due to trauma to the bone - when it is drilled, pressed with an instrument, or even broken during the removal process.

Basically, any pathological manifestations of numbness in the lip, cheek or gum that does not go away for a very long time after tooth extraction indicate errors on the part of the dentist. For example, if you have not prepared properly for the procedure - you have not studied the condition of the bone, the position of the tooth in the jaw on an x-ray. Or if the needle was inserted too deeply and hit the nerve itself. After all, the anesthetic must be injected near the nerve trunk. Also, sensitivity may not return for a long time if inflammation has developed - for example, alveolitis. Inflamed tissue and accumulation of pus can also put pressure on the nerve, preventing it from recovering.

Interesting to know! As a rule, long-term numbness of the cheek or tongue after tooth extraction persists if the operation was on the lower jaw and not the upper. Most cases of paresthesia are associated with the removal of “eights” or wisdom teeth, because they are located in hard-to-reach areas of the row, and large branches of the trigeminal nerve pass near their roots.

How it manifests itself

Paresthesia after tooth extraction should not be confused with the effect provided by the anesthetic. The latter passes without a trace in 4-6 hours. The development of complications is indicated by:

• numbness of part of the face (the patient complains

  
  that a separate area becomes as if plastic, hard);

• running “goosebumps” all over the cheek;
• unpleasant burning sensation;
• painful sensations.

These symptoms may last from several days to several months. Sometimes it is possible to get rid of them only after a year. In the latter case, it is customary to talk about a persistent or chronic form of the disease.

Wisdom teeth removal is one of those dental procedures whose necessity is still debated among experts. And yet, in some cases it is impossible to do without it. At the same time, this operation does not always take place without unpleasant consequences. It is the direct responsibility of the doctor who performs the tooth extraction to warn the patient about possible complications.

Dry socket

This is one of the most common problems after removing "eights".

After the operation, a blood clot should form in the socket at the site of the extracted tooth. It is necessary for the healing process to proceed effectively. If the clot does not appear or leaves the hole prematurely, it remains dry.

As a rule, most often a dry socket forms after complicated operations - for example, when the surrounding tissues are severely injured during tooth extraction.

Main symptoms of dry socket:

• sudden acute pain at the site of the eliminated tooth, appearing 3-4 days after surgery;
• “return” of this pain to different places of the face or head - it may even seem, for example, that the ear or temple hurts;
• bad breath.

To treat a dry socket, it is necessary to apply a cotton swab containing a medicinal solution to the site of the extracted tooth. This helps calm the nerves and thereby relieve pain. The cotton swab must be changed every day until the pain is completely eliminated (in most cases, the pain goes away after 2-3 days).

Swelling

Swelling after tooth extraction In addition to pain, some swelling may appear at the site of the extracted tooth. As a rule, swelling is associated with injuries caused during the procedure to eliminate the tooth. The more severe the damage, the higher the risk of swelling.

To eliminate such consequences of the operation, it is recommended to use cold compresses. The compress should be applied to the cheek for 10 minutes, and then take a break for about a quarter of an hour. Usually, several such procedures are enough to relieve swelling.

If the swelling does not subside within two to three days, warm compresses are used (for example, a warm, damp towel). They are applied to the cheek for a third of an hour, and a break is taken for the same time before the next procedure.

Paresthesia

Paresthesia after tooth extraction Paresthesia is prolonged numbness of the lips, chin, and tongue. After the removal of wisdom teeth, such a complication, although very rare, still happens. The cause of such a problem can be inaccurate operation - it happens that wisdom teeth are located very close to the jaw nerves, and the dentist touches them during the removal procedure.

The duration of paresthesia varies from patient to patient: in some patients it goes away within a couple of days, in others it can last up to several months. If the nerve is damaged too much, the patient may have paresthesia forever.

How to treat

In the first days of numbness, get medical help

not necessarily, since there is a high probability that everything will go away on its own. Only if painful symptoms persist for more than a week should you make an appointment with the doctor who performed the dental surgery.

Since nerve fibers react very sharply to oxygen deficiency, the process of complete recovery takes a long time. The patient may be offered the following treatment options:

• medication;
• physiotherapy;
• surgical.

Medicines for paresthesia after tooth extraction

To restore the functions of the damaged nerve, the patient is prescribed drugs that reduce blood viscosity and stimulate local blood circulation. Good results can be achieved by taking B vitamins.

Physiotherapy

Physiotherapeutic procedures are usually used along with drug therapy. Among the most effective for the described disease:

• Magnetic therapy. It consists of influencing nerve fibers with a magnetic field. Perfectly removes swelling and relieves inflammation.
• Use of electric currents of ultrahigh frequencies. It is designed to relieve muscle tone, increase blood flow to the numb area and block the further spread of inflammatory reactions.
• Introduction of drugs into the area of ​​paresthesia using electrical discharges of minimal intensity. The procedure is designed to quickly restore damaged tissue, relieve pain, and combat the feeling of crawling “goosebumps”.
• Mud therapy. Has a general strengthening effect. Helps increase the body's defenses.

Surgical treatment of paresthesia

Operations for this diagnosis are performed very rarely - only if it is not possible to achieve positive dynamics with the help of medications and physical procedures. The oral and maxillofacial surgeon is responsible for the surgical intervention. After administration of the anesthetic, it restores impaired nerve conduction.

Causes of pain

The further a tooth is in the row, the more difficult it will be to remove, as it has a more extensive root system. This often leads to inflammation and improper healing of the hole. According to statistics, complications are most often diagnosed after the removal of wisdom teeth (eight teeth). Also, the cause of long-term toothache is the lack of experience of the dental surgeon and incorrect removal tactics.

Let's look at the main complications that lead to long-term pain after tooth extraction:

1. Bleeding – Bleeding normally stops within 30 minutes of surgery. But in people with diseases of the hematopoietic system, diabetes mellitus, the hole may bleed for several hours. The critical period is the first day. If you experience even slight bleeding during this time, consult your doctor. He will perform additional tamponade, diathermocoagulation or suturing of blood vessels.
2. Alveolitis is a common infectious complication that is characterized by inflammation of the soft tissue around the socket. There are aching pains that intensify while eating. As the disease progresses, pain may radiate to the temple and ear on the affected side. Treatment by a dentist is required. Untimely treatment can lead to the development of an abscess and blood poisoning.
3. Paresthesia is a loss of sensation that occurs when the mandibular or maxillary nerve is injured. Normally, the numbness goes away within 1 or 2 weeks. To reduce the period, physiotherapeutic methods are used. If discomfort persists for more than a month, you need to contact the dentist.
4. Leaving tooth fragments in the wound - foreign objects in the socket interfere with the normal healing process, which leads to prolonged pain and inflammation. Small fragments may come out on their own when rinsing. X-ray diagnostics are required.
5. An abscess is a purulent process that occurs in a hole as a result of infection. Accompanied by throbbing pain, fever, headache, and weakness. An opening and drainage of the abscess and antibacterial therapy are required.
6. Osteomyelitis is an inflammation of the bone tissue of the jaw. Accompanied by acute pain, unpleasant odor, mobility of adjacent teeth, and swelling of the jaw. Pathological changes in bone tissue are visible on x-rays. In advanced cases, surgical treatment is required. Without treatment, the infection can spread to the soft tissues of the face and neck.

The most common cause of long-term pain after tooth extraction is the absence of a blood clot, that is, a “dry socket.” This pathology is often observed in older people, smokers and in patients with hormonal disorders.

Why paresthesia needs to be treated

Some patients whose symptoms are mild refuse treatment. They get used to living with a numb part of their face and do not want to devote time to long-term treatment measures. You can't do that.

The fact is that in the absence of the necessary therapy, the entire sensitive part of the nerve can be affected. Then the sensitivity of a separate part of the face will be lost completely and forever. Therefore, in order to avoid such a complication, you must definitely consult a dentist if paresthesia does not go away on its own.

How to avoid paresthesia

To ensure that any tooth extraction occurs without complications,

you need to approach it wisely. Before surgery, the patient must undergo x-rays and an orthopantomogram. These methods will allow the doctor to study the structure of the root system of the tooth and draw up an effective plan for the upcoming treatment. An experienced dental surgeon should be responsible for removal.

It is necessary to understand that fear of possible complications is not a reason to postpone treatment until later. Trust your health to talented specialists, and then everything will be fine. Call our clinic and make an appointment.

Injuries during tooth extraction

They are considered a complication, most often appear on the upper jaw, the highest risk is when removing premolars and molars. If removal is difficult, there is a risk of perforation of the floor of the maxillary sinus. It becomes damaged, and a hole appears in the bony septum between the nasal and oral cavities. This may be due to the anatomical features of the jaw structure (there is no bone septum or the roots of the teeth being removed are located close to the bottom of the sinus). Another possible cause is chronic inflammation in the area of ​​the tooth root, due to which the bone septum becomes thinner and destroyed. Such an injury is eliminated immediately. If this is not done, liquid may enter the nose when swallowed or chewed. If such a symptom appears, you should contact your dentist so as not to provoke inflammation.