Tooth Extraction Complications: Inferior Alveolar Nerve Injury – Part 2

Oral and maxillofacial surgical procedures such as tooth extractions can sometimes result in damage to the anatomical area surrounding the tooth. Though approximately 98% of oral surgery procedures can be successfully completed without incident, there are some risks that must be brought to your attention.

An inferior alveolar nerve injury, a serious injury to the sensory nerve that runs the length of the lower jaw, is an example of a well-known risk associated with the extraction of a lower tooth, particularly impacted teeth, that can result in numbness of the lip and chin area.

In most cases, the potential for nerve damage mainly depends on the anatomic relationship between the nerve pathway and the tooth that is to be removed.  When the nerve and the tooth are relatively close together, there is a higher risk of nerve damage during the surgical procedure. In some instances, the nerve can run dangerously between the roots of the lower teeth.

The risk for nerve damage can be assessed with information gathered from your x-ray, but only an advanced film like a 3D CT scan. The nerve pathway and the position of the teeth and roots cannot be accurately visualized and determined on a 2D dental panoramic x-ray.

The inferior alveolar nerve is a branch of the Trigeminal Nerve, which is one of the 12 cranial nerves in the head and neck region.  This particular branch carries only sensory fibers and no motor fibers, therefore, it is not responsible for movement – only sensation, i.e. Temperature, pressure, pain, light touch, vibration.  The most common consequence of inferior alveolar nerve damage is prolonged numbness or tingling of the lip or chin. For some patients, this sensation may continue for several weeks, and for others, many months. The great majority of patients will see a full recovery within a year.   The incidence of permanent injury is less than 1-2%.

Complications such as nerve damage can arise, even in the hands of a highly skilled oral surgeon. These unexpected occurrences should not be attributed to a lack of care or skill on behalf of the oral surgeon, and every reasonable measure will be taken to avoid any damage at all.  In fact, prior to the removal of the tooth, your surgeon will assess the risks versus the benefits to determine if the procedure should be performed at all.

To learn more about the risks and the benefits of oral surgery and tooth extraction, call the office of Dr. Steven Koos to schedule a consultation today.