Dentistry/Still numb after root canal 4 days ago.
QUESTION: Thank you for taking my question. Monday 9AM, I had the second step of a root canal done. (tooth 19 - lower left). I notified my Dentist the next morning, that I was still almost completely numb (24 hrs later). By that afternoon (Tues.) they prescribed Medrol Dosepak and advised me to begin that and keep taking the Cephalexin (500 MG). It is now Friday afternoon and I have gained only about 10-15% feeling back. I still feel completely numb with only slight tingles on my jaw line and lips. When I spoke with them Tuesday they told me the root was a deep root and that it was very close to a nerve. They say the nerve might have been penetrated. I've heard everything from.."it could take 6 months to a year to recover"...and also.."people learn to live with this". I realize you can not predict my outcome, but I wanted to get some feedback from someone in the field who may have encountered this. Blessed regards.
ANSWER: Hi Heather....before I answer your question, I have one question. When you were getting the shot to get numb, did you feel like an electric shock on your lip during the actually injection process?
Gary Backlund DMD, MSD
---------- FOLLOW-UP ----------
QUESTION: To answer your question, I do remember a bit of a shock but it wasn't what I call "that bad". What we did discover after an x-ray (taken by the machine that travels around your head) that the sealant (their words) exited the bottom of the tooth (19) and is now attached to the nerve. It's been 7 days and I have about 20-25% feeling in my lower left jaw. Still feels like a fatty mass. I'm experiencing great pain (and I have a pretty high threshold) which requires me to take a pain reliever every 4 to 4 1/2 hours without fail or it's unbearable. Dentist said I can wait to see if the feeling comes back but it may take up to 6 months, or remove the entire tooth right now. My fear is since the sealant is on the nerve how do we make sure that extracting the tooth will actually remove the sealant from the nerve and not damage it farther? Dentist also suggested that the pain might be coming from the tooth behind (18) that has a filling and recommends a root canal on that one now too. I'm not comfortable with that. Could the sealant on the nerve be causing this numbness? Could it also be causing the extreme pain? Thank you for your time.
Hi again Heather,
Thanks for the additional info. It's hard for me to give you exact info without being able to exam you or see your X-rays, but I can share a few thoughts.
There are 3 possible reasons for your numbness remaining...one is that the sealer has entered the nerve tract bundle. We do see this sometimes, but not frequently. An Xray, even the kind that goes around your head, is 2 dimensional and the sealer may or may not be in the canal. It could be in front or behind the canal and appear like it is inside, but really isn't. I would think this would be the most unlikely cause of your problem.
The next would be residual from the injection. Sometimes when we give a shot we get a "bulls eye" where the needle actually hits the nerve. That causes a shock feeling on the lip and the needle will do some temporary nerve damage that will cause the lip and/or tongue to go numb or partially numb until the nerve heals. That can take anywhere from a week to several months.
The third, and what seems most likely in your situation, is that finishing the root canal has cause inflammation and swelling inside the jaw. That puts pressure on the nerve and you will loose feeling in your lip and the side of your jaw. We see this frequently and when the infection goes away, the feeling comes back. The fact that you have a lot of pain and things feel like a fatty mass makes me think you still have an unresolved infection.
Your dentist did bring up a couple of other issues that need to be resolved. One is the status of #18. It could be part of the problem, but you are very wise to be suspicious. I would make sure that tooth needs a root canal before consenting to treatment. The other is extracting the tooth. If sealer is actually in the nerve canal, extracting the tooth will not help since the sealer will remain. If all this is from an infection, then extraction will help, but there are other, less invasive ways to deal with this.
Bottom line, I would suggest that you get a 2nd opinion, from an endodontist, about what is going on here. You can ask your dentist for a referral or just find one in your area. You need a GOOD diagnosis so you don't get treatment you really don't need. It may be as simple as changing your antibiotics.
Hope this helps.
Gary Backlund DMD, MSD