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A surgical wisdom tooth extraction is a technique sensitive procedure that can result in certain complications if everything does not go to plan. Nerve damage is one of the more serious complications that patients need to be aware of.

A wisdom tooth extraction is something that most of us will have to experience in our lifetimes. It is not something that should be feared but does require some understanding. Wisdom teeth or third molars are the last teeth to erupt into the mouth. They do not serve any purpose and are considered as evolutionary remnants. This is why they are the most commonly extracted teeth in the mouth [1].

The lack of space available to the wisdom teeth for extraction also makes them difficult to extract. In fact, a minor surgical procedure may have to be performed in a lot of the cases. Like all surgical procedures, small or big, there is the possibility of some complications occurring [2].

Infection after wisdom tooth removal is the most common complication. The most serious one, though, is nerve damage after wisdom tooth removal.

Nerve damage after wisdom tooth removal

Why does it happen?

Nerve damage is most common after the removal of the lower wisdom tooth. The position of the nerve running through the center of the lower jaw is anatomically very close to the lower wisdom tooth. Sometimes, the nerve can actually be traveling in between the roots of the lower third molar [3].

In such a case, the process of removal of the wisdom tooth some amount of damage can occur to the nerve [4]. This damage is quite transitory for most of the affected people but in the worst case, it may be permanent.

How can it be prevented?

The best way to prevent nerve damage from happening during a wisdom tooth extraction is to follow proper planning. This is not something that you as a patient can really do but the doctor should ideally take a CT scan of the area if a regular x-ray indicates the nerve may be close by [5].

The other method is to follow a conservative method of extraction without cutting too much of bone. Complicated cases should be referred to oral surgeons that have experience in dealing with such situations [6].

Symptoms of nerve damage after wisdom tooth removal

The kind of symptoms will depend on the amount of damage that has taken place to the nerve. If the nerve has just been shocked or received an increased amount of pressure during the extraction then the patients may feel a tingling sensation on the lip and tongue on the side of the extraction. The symptoms will last for a week or two and then subside [7].

If some more damage has occurred to the nerve without it being severed then the tingling may last for a few months. Patients may also report numbness on the side of the jaw where the extraction took place. The numbness starts to diminish slowly over a period of time before returning back to normal [8].

The most severe symptoms are seen in cases where the entire nerve has been severed. The damage, in this case, is permanent and may never heal. Patients will feel numbness on the side of the extraction, difficulty in carrying out other functions such as talking, chewing, swallowing, and blowing air [9].

Treatment

Nerve damage is notoriously slow to heal. This is why it is recommended that no surgical intervention be done for the first year after the nerve damage has occurred. Patients will be put on nutritional supplements that are believed to help promote nerve regeneration and a few mouth exercises will be advised as well. Unfortunately, this is pretty much the extent of the non-surgical treatment that can be provided.

The affected patient should be recalled at regular intervals and then evaluated. If there is no improvement in the symptoms then the patient may have to consider surgery as an option. In this procedure, the two ends of the severed nerve are joined to each other in order to return the nerve to normal function [10].

As mentioned earlier, nerve healing is very slow and difficult to predict. The success of this surgical procedure to bring back complete nerve function is very low. However, in a large majority of the cases, some amount of nerve function should return.

For patients that have been affected by a complete loss of sensation and function, even a marginal improvement after surgery can be considered a success.

Conclusion

Nerve damage after wisdom tooth removal is one of the major complications that can occur. It is, however, something that happens very rarely. Even in the instances where it does happen, the most severe symptoms are seen only in a small percentage of the people. If the proper planning for wisdom tooth extraction and the proper technique is followed, nerve damage is not something that patients should be worried about.      

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