Expert: Joel S. Teig, DMD, Diplomate ABOMS, retired - 12/1/2009

Question
I had an extraction on 10-28-09 from an abscessed tooth.  Since the extraction I have no feeling in my lip and chin.  I went back to the dentist and he tested my teeth with electricity and gums and the nerves seem to be intact.  He also did an x-ray and there isn't a cyst.  He said I am just experiencing paresthesia in the isolated area in my lower lip and chin and is probably related to the trigeminal neuralgia. From all of my research, it sounds like to me some nerves have been damaged.  But from what the dentist said, if a nerve or nerves have been damaged, I would not be feeling anything from the injection site backward and forward, not just forward.  The tooth that was removed was the second molar in the back on the bottom.
Something isn't lining up, and I now have to go to the University of Iowa Dental Clinic because no one in the state besides them is equipped to give me an answer.
I was just curious to get another opinion.

Answer
Amy - It is quite obvious that the numbness in the lip and chin is directly related to the extraction.  The numbness could be from the extraction of the tooth by direct trauma to the nerve, which runs in the jaw bone under the roots of the teeth, or it could be from the injection of novocaine (the doctor would have been very accurate and actually hit the nerve with the needle).

It is now a slightly more than a month after the extraction and you have been numb for that time.  If you have sensations, along with the numbness, of itching, burning or even shocks, then that means that the nerve is healing.  If, however, there is complete numbness with no sensations whatsoever, that is an indication that the nerve is not healing now.  Will that nerve heal?  I cannot tell you, but if by 2 months there is only numbness and none of the sensations of itching, burning or shocks, then you need to see a board certified oral and maxillofacial surgeon for an evaluation.  Sometimes, if a nerve is badly injured, it may need to be surgically repaired.  It is too early to tell if that is a possibility, but you need to be totally aware and, if by two months there is still numbness, see the board certified oral and maxillofacial surgeon.

I wish you well and hope the numbness just gets better.  If you have any additional questions, feel free to contact me again.