Should bilateral inferior alveolar and lingual nerve blocks be given for wisdom teeth surgery?

An interesting article titled “Should we be giving bilateral inferior alveolar and lingual nerve blocks for third molar surgery,” appears in the British Journal of Oral and Maxillofacial Surgery and written by J. Jabbar and et al. (2014, vol. 52, pp. 16-17). The article discusses how when someone is having their wisdom teeth extracted they are usually given general anesthesia and 2 inferior alveolar nerve blocks or local anesthesia in one or two visits. The authors feel there is controversy over whether 2 inferior alveolar nerve blocks should be given to patients in a single visit.

The authors say the most common complications thought to be associated with bilateral inferior alveolar nerve blocks are injury to the tongue during anesthesia, unpleasant effects, loss of control of the tongue, and bilateral anaesthesia of the tongue, which can lead to collection of fluid in the oral cavity and aspiration. The authors mention a few past studies that have been conducted to look at lingual movement from bilateral anesthesia. Possible speech and articulation problems can arise. It is also possible the delay of lingual movement can cause a week bolus propulsion during swallowing.

The author state that as of the study being published there is only anecdotal evidence on the incidence and complications that can happen from bilateral inferior alveolar nerve blocks. There are no guidelines available. In addition, some surgeons use the technique and others do not. The authors feel more research is required so that patients may have better experiences and successful surgeries.

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