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Oral Surgery/Wisdom tooth extraction

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QUESTION: I got all four of my wisdom teeth extracted November 27. The right side was fairly simple and is healing with minimal pain (I won't include details to save space). The left side wasn't so simple and the healing on this side is painful and annoying. After the lidocaine wore off the first night, I noticed that the left side of my lip, chin, and a few teeth remained numb. Additionally the left side of my lip is swollen. I expected this to go away, but it is now December 2nd and nothing has changed at all. I follow all of the dentist's post op instructions. Could you give me some insight on what's going on.

ANSWER: Margaret - From your description of the numbness after the extraction of the wisdom teeth, in the extraction of the lower left wisdom tooth, the mandibular nerve, which runs below that molar and the other teeth on the lower jaw.  During the extraction, pressure on the nerve or damage to the nerve occurred.  It is also possible that the local anesthetic given by the dentist via a needle pierced the nerve.  

With simple damage, like trauma to the nerve, the best thing for you to do is to just wait.  If the damage was minimal the nerve will be restored or beginning to get better by two months.  If no change has occurred by about 6-7 weeks after the extraction, you should have yourself evaluated by a board certified oral and maxillofacial surgeon.  Most of the time nerves get better, but if the numbness is still there, the damage might be permanent and then the nerve might need to be treated.

So it is early to worry, but if by the second week in January no change has occurred (the early changes are itching, a feeling of a shock, burning or the numbness improving)you should seek an evaluation.  I hope the numbness resolves and you do not have to worry.

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

---------- FOLLOW-UP ----------

QUESTION: Thanks so responding so quickly. I have another question though.
Is the nerve damage the cause of my swollen lip?

Answer
Margaret - The nerve damage will not directly produce swelling, but because the muscles of the lip are not aware of what they are doing, very often the lip will be flaccid (loose and floppy in appearance).  This flaccidness can be viewed by some as swelling because the loss of ability to control its normal position.

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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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