An interesting article titled “Numb chin syndrome: What all oral health care professionals should know,” written by Christina Perez and et al. appears in the Journal of the American Dental Association (published May 26, 2022). The article discusses the rare sensory neuropathy of the mental nerve called numb chin syndrome (NCS) and to inform oral health professionals and dentists of the clinical characteristics since they may be the first to encounter it in their patients.
In the article the authors found a total of 2,374 studies in PubMed and the Cochrane Library. Based on the authors inclusion and exclusion criteria 102 articles were left. From these 102 articles, 8 studies were observational, 85 were case reports, and nine were letters to the editor. The articles included 288 patients which the authors performed descriptive statistics on. This resulted in numb chin syndrome being associated with malignancy in 29% through 53% of the cases.
More than one-quarter (28%) of these patients initially consulted an oral healthcare professional with concern of a numb chin. Further 28% of these patients first consulted an oral health care professional for a numb chin. The authors found that patients between the ages of 61 and 70 were more likely to have NCS. Further 74% of the cases of NCS were were unilateral and the most common symptoms reported were numbness (100%), paresthesia (18%), and pain (17%). Anecdotally, it was reported that patients with NCS had an increased frequency in lip biting which led to painless ulcers. Further the authors found that 47% of the NCS cases were associated with a recurrent malignancy. In addition the most commonly associated diagnoses were breast cancer (32%) and lymphoma and leukemia (24%).
The authors feel that oral healthcare professionals should be aware of how to make a diagnosis of NCS. They feel that oral healthcare professionals should take a thorough history of their patients and conduct an examination while emphasizing questions related to a patient’s history of cancer. Further they feel that patients paritculary experiencing numbness should have a detailed cranial nerve screening performed along with an intraoral exam of the soft tissues and dentition. The authors feel that to date the symptoms of NCS are often overlooked due to their innocent nature but that a numb chin may help with the diagnosis along with the associated malignancies.
The authors point out that oral healthcare professionals should be perceived differently than in the past due to their role in detecting conditions like NCS. The authors state:
“Oral health care professionals should be aware of the characteristics of NCS as they may be the first health care providers consulted for these symptoms.”
The authors mention that the oral cavity is a source of numerous information about the overal systemic health of a patient. Being able to make a postive impact on the overal health of a patient is of course a great benefit to the oral health profession such as dentists, oral surgeons, and their staff as a whole. Helping to diagnosis numb chin syndrome is just one example.