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Oral Surgery/Lingual nerve damage

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QUESTION: Hi, I had my bottom wisdom tooth surgery on 24 March. I had a sensation of pins and needles in my tongue the first week after my surgery which disappeared after 8 days of my surgery. Then on the day 8 I started to have a sensation of throbbing burning in my tongue. on 10 April my tongue became better but then it became worse. Then the throbbing disappeared. It became better on 17 and then it became worse again. Since 22 April my tongue became worse again like before; it is a constant painful burning sensation in my tongue (the anterior two parts of my tongue) and sometimes with stabbing sensation to the extent that I find it difficult to eat. My lower front teeth hurt some days and get better on other days. How sever is my case? my SD said that my lingual nerve might be stretched. I had a pain and jumped when he was trying to make the root loose. Is there a possibility for the my nerve to heal itself? and what is the average time for it to heal itself from the symptoms I have? thanks.

ANSWER: April -  The extraction itself might have cause the nerve injury if the dentist pinched the nerve during the extraction or if any cutting was done and the nerve was nicked.  The good news is that it is early in nerve healing.  Lingual nerve injury, if it is not extensive, can usually heal on its own, if the nerve was just mildly traumatized.  Usually the healing can take a couple months.  So for now leave it alone, but if by late June it is still present or has gotten worse, repair of the nerve might be considered.  From your description of the injury and how the sensations change, I would suggest just leaving it alone for a while and it should heal.  It can take a few months for complete healing.

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QUESTION: Thanks for your help. You mentioned ''Lingual nerve injury, if it is not extensive, can usually heal on its own, if the nerve was just mildly traumatized''. My question is how can I know if it is mildly traumatized? thanks.

ANSWER: April - a mildly traumatized nerve does not produce complete numbness in the area that the nerve is.  The sensations are usually itching, burning, shocks or occasional numbness.  Those alone define a nerve trauma, but because your symptoms vary, it usually means that the nerve is traumatized and in certain position it irritates the nerve  and makes the symptoms remain.  

My suggestion, that helps to reduce inflammation and at the same time promote healing, is to begin a simple regimen of warm salt water rinses in the area of the surgery.  Do the warm salt water for 1-2 minutes, 4-5 times a day.  The warm salt water increases the blood flow to the region and helps the healing.

I wish you well and hope you are completely healed soon.  Any more questions, feel free to contact me again.

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QUESTION: Hi,I have been having pain in my lower front teeth since 2 April. My teeth have become sensitive to cold liquids and air (but they get more sensitive and almost frozen when I am outdoor as the weather is cold here). They get worse when I talk and when the weather is cold (Typical British weather). It has been five weeks and six days since my surgery. My lingual gum hurts as well.On some days my lower front teeth were better than other days, but they hurt too much at the moment.Or it might be because I have had different sorts of pain in my tongue, lingual gum, ear, and lower front teeth, I just pay more attention to the worst one every time. and  My left ear and left jawbone joint (in front of my ear) hurt when I chew or open my mouth.

What is the reason behind this pain in my lingual gum, lower front teeth, and my ear? Is there any medication or remedies that are helpful?

Do these also heal on their own as time goes on?

I wanted also to ask about the lingual nerve: is there a possibility for a traumatized lingual nerve (based on the symptoms that I mentioned before) to fully recover and be back to normal? (by the way my tongue gets worse and painful when I eat)how can I deal with this problem?

There is also some internal tightness in the lower part of my left jaw and I can notice it when I talk or when I stretch my lips to the right. It is not painful, but I am just wondering what it is. As it might be one of the reasons behind those problems that I have got. I also noticed that the left gum (the inside of my left cheek) is bigger than the right side.

At the moment I am using warm salted water rinse as you told me before.

I do appreciate any help.
Thank you

Answer
April - With the symptoms you now describe, seeing a board certified oral and maxillofacial surgeon now is important to define the problem and correct it.  The tightness sounds muscular, but there is a combination of problems that need to be evaluated by a surgeon.

If you have additional questions, feel free to contact me again.

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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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