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Oral Surgery/recent tooth implant nerve injury

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Question
Happy New Year.  Monday 12/31/12 Thank you for taking the time to review my issue. Had a lower left tooth extraction and 2 implant posts drilled into my jawbone on 12/19/12.  Since that time, I've had extensive numbness and strange tingling feeling which I brought to attention of my oral surgeon.  We also discussed these remaining symptoms last week when I had the sutures removed and verified that the nerve involved would be inferior alveolar.  He assured me that there is some numbness which can take several weeks due to the "invasive" nature of the surgery.  I continued to press for CT Scan to determine the cause and finally after increasing PAIN which is current, he has agreed to do a panoramic x-ray (2 dimensional) on Weds and if needed will schedule the CT scan for Thursday. I spoke to a neurologist who thought this would be protocol as I opted to omit the 2 dimensional panoramic xpray and go right to the CT Scan if it was more complete. I'm hoping they can rectify this matter as I would hate to think I have to suffer like this long-term.

Answer
Ric -  You are so correct.  A two dimensional xray view, unless the invasion of the nerve canal is in those two dimensions, is insufficient to determine how and where the nerve was violated.  It could be that just backing off the implant may be enough or the implant may have to be removed.  Of course, I cannot be sure, but I am a little surprised that an oral surgeon, unless he is not board certified, is mnot willing to know everything about the cause of the numbness and address it.  

So the surgeon should immediately send you for a CT to know the dimensional aspects of the cause of the trauma or damage to the nerve.  Hopefully, it is just pressure on the nerve by the implant.  It can then be backed out a little to eliminate the pressure.  

So insist that the CT be done now.  Do not take no.  If the doctor gives you a difficult time, either have the neurologist send you or find a different board certified oral and maxillofacial surgeon to evaluate you and send you for the CT.

I wish you well and hope the surgeon is above board and honest with y9ou.  If you have any questions, feel free to contact me again.

Oral Surgery

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Joel S. Teig, DMD, Diplomate ABOMS, retired

Expertise

I am a board certified oral and maxillofacial surgeon available to answer questions related to tooth extractions, implant insertion, facial recontruction, facial and oral tumor removal, TMJ dysfunction and various successful treatments, including surgery if all else fails, and occlusal discrepancy requiring orthognathic or jaw surgery.

Experience

Board Certified Oral and Maxillofacial Surgeon practicing for over 20 years. Assistant Clincal Professor at State University School of Dentistry.

Organizations
American Dental Association, American Association of Oral and Maxillofacial Surgeons, American Board of Oral and Maxillofacial Surgeons

Education/Credentials
BA- University of Connecticut DMD-University of Pennsylvania School of Dental Medicine Oral and Maxillofacial Surgical Residency - Roosevelt Hospital, NYC

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