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Long Term Effects of Trigeminal Nerve Injuries from Dental Care

Posted on 03. Oct, 2011 by in Wisdom Teeth

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A study was published in the Journal of Oral and Maxillofacial Surgery titled “Long-Term Outcome of Trigeminal Nerve Injuries Related to Dental Treatment” by M. Anthony Pogrel, Ryan Jergensen, Eric Burgon, and Daniel Hulme. (vol. 69, pages 2284-2288, 2011) that looked at long-term effects of those who suffer from permanent nerve injury from dental treatment particularly involving the third molars or wisdom teeth.

A total of 145 patients with 95 female and 50 male patients were involved in the study who had suffered a trigeminal nerve injury affecting either the inferior alveolar nerve or lingual nerve and in 8 cases both nerves. Nineteen patients (13.1 %) reported that their employment was affected, while 21  patients (14.5%)  reported problems with their relationship, 53  patients (36. 6%) reported depression, 55  patients (38%) reported problems speaking and pronouncing words correctly, 63  patients (43.5%) reported problems eating, and 1 patient reported a significant change in his appearance. Twelve patients (8.2%) were reported to have gone on to make a late full recovery.

Some of the coping mechanisms the patients used include getting used to it (64), prayer and mediation (7), ice and heat packs (3), pressure on teeth (3), exercise and yoga (3), antidepressants (2), chewing gum (2), relation and acupuncture (2), and other methods included keeping a journal, alcohol, massage, and herbal medicines.

The authors state:

“In this study, the encouraging news is that in general terms, patients did tend to improve with time, with over 8% going on to full recovery, although it is unclear in some cases whether this recovery was a true neurological improvement or the development of coping mechanisms.”

It is not clear from the results if the improvement in symptoms in a few of these patients was due to and an actual improvement or just the better ability to cope. I agree that I think this is hard to say.

The authors also mention the ability for surgical exploration which did not occur in all these patients but is a possibility within 9 months after injury to the trigeminal nerve following a wisdom tooth extraction

  • Patients with a witnessed transection
  • Patients who are still totally anesthetic at 8 weeks postinjury, with no signs of recovery
  • Patients with severe dysesthesia at 8 weeks postinjury, who are showing no improvement
  • Patients at 4 months postinjury, who have less than 30% return of function (or do not have protective reflexes), or have severe dysesthesia

For the patients in the study who did have surgery some were helped but none fully recovered.

Consequently many of these patients suffered from a permanent decrease in their quality of life.

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