Nerve Injury Diagnosis and Treatment

• Trauma: A forceful impact to the face or jaw may fracture or displace teeth and injure the nerves connected to them.
• Tooth Decay: As cavities progressively break down enamel, the underlying nerve tissue becomes exposed, leading to pain and inflammation.
• Bruxism: Chronic clenching or grinding of the teeth places excessive stress on the jaw and can cause nerve damage over time.
• Gum Disease: Severe periodontitis may cause the gums to recede and expose tooth roots, putting nearby nerves at risk of injury.
• Infection: Bacterial infections originating in the teeth or gums can spread into adjacent tissue, triggering inflammation that may compromise nerve function.

Although dental and oral surgical procedures are overwhelmingly safe, nerve injury can occur in rare cases.  At Norwell Oral Surgery and Dental Implant Center, Dr. Helal and Dr. Colton use advanced Cone Beam 3D imaging to map nerve pathways before treatment, minimizing risk. However, even with the most careful surgical technique, nerve injury remains a possibility during certain procedures.

• Tooth Extractions: Removal of impacted wisdom teeth in particular can place pressure on or directly affect the inferior alveolar nerve or lingual nerve.
• Dental Implant Placement: Implant surgery demands precise technique and planning. The inferior alveolar and mental nerves are at potential risk during implant placement in the lower jaw.
• Root Canal Therapy: In uncommon instances, the instrumentation used during root canal treatment may irritate or injure a nearby nerve.
• Deep Fillings: Larger restorations placed in close proximity to the nerve chamber may cause irritation or inflammatory responses.
• Sinus Lifts: The infraorbital nerve may be affected during sinus augmentation procedures in the upper jaw.

The signs of a dental nerve injury depend on which nerve has been affected and the extent of the damage. Patients should be aware of these common indicators:

• Numbness: A partial or complete loss of feeling in the lips, chin, tongue, or cheek area is among the most frequently reported symptoms of nerve damage.
• Tingling or Pins-and-Needles Sensation: An abnormal prickling or buzzing feeling in the affected region, even without any external stimulation.
• Pain: Nerve-related discomfort can vary from a dull, persistent ache to an intense, burning sensation. In some cases, patients experience phantom tooth pain in the area of a previous extraction.
• Trouble Chewing or Speaking: Nerve damage that affects the muscles controlling jaw and tongue movement can make eating and speech more difficult.
• Changes in Taste: Injury to specific nerves, particularly the lingual nerve, may alter or diminish the ability to perceive taste.

Pinpointing the source and severity of nerve injury requires precision. At Norwell Oral Surgery and Dental Implant Center, Dr. Helal and Dr. Colton employ a thorough diagnostic process:

• Clinical Examination: A detailed evaluation of your symptoms paired with a focused neurological assessment.
• Medical History Review: A careful review of your overall health background and any conditions that may influence nerve function or recovery.
• Radiographic Imaging: Advanced imaging using our in-office Cone Beam 3D (CBCT) technology provides detailed visualization of neural pathways and helps identify areas of compression or structural damage.
• Nerve Conduction Studies: Specialized testing that measures the speed and strength of nerve signals to determine the degree of injury.
• Electromyography (EMG): An assessment of muscle activity that helps reveal nerve damage impacting muscular function in the face and jaw.

The appropriate course of treatment is determined by the nature and severity of the nerve injury. At Norwell Oral Surgery and Dental Implant Center, Dr. Helal and Dr. Colton provide a comprehensive range of treatment options:

• Conservative Management: Many mild nerve injuries resolve gradually on their own. Our team may recommend anti-inflammatory medications, targeted physical therapy, and careful monitoring over time.
• Medications: Prescription pain management, neuropathic agents (such as gabapentin or pregabalin), and corticosteroids can be used to control symptoms and support healing.
• Physical Therapy: Guided exercises and therapeutic techniques can help restore nerve function and rebuild muscle strength in the affected area.
• Surgical Intervention: When nerve compression or entrapment is identified, surgical decompression may be required to relieve pressure. As board-certified oral and maxillofacial surgeons, Dr. Helal and Dr. Colton are highly qualified to perform these procedures.
• Nerve Grafting: For cases involving significant nerve damage, a nerve graft procedure may be recommended to reestablish nerve continuity and restore sensation.