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Root canal related nerve injury

If you have had a lower jaw tooth root canal and you have noticed that your lip is still numb or tingling and or painful after more than 6 hours after the treatment, you may have prolonged neuropathy (nerve injury). You should contact your surgeon to let them know.


If you experience a severe / excruciating pain during treatment of the tooth or severe pain during the dental injection the nerve injury may have happened at this time. Extreme pain after surgery may also be a sign of nerve damage. If suspected nerve injury occurs during treatment then your surgeon is responsible for immediate treatment by a specialist.


If the lip and gums remain changed in sensation the next morning you MUST CONTACT your dentist immediately to discuss possible removal of your implant if it is too close to the nerve within 36 hours in order to maximise the recovery of the nerve.


You may benefit from taking early medical treatment;

 

  • steroids (Prednisolone step down over 5 days (50/40/30/20/10ms)
  • non-steroidal anti-inflammatories (Aspirin or Ibuprofen 400-600mg TDS) to reduce any nerve related inflammation

in addition vitamins B 12 complex (injections or oral) may assist minimising damage to your nerve but there is limited medical evidence to support these supplements.
(always check that your medical history does not prevent you taking these drugs)


If the lip and gums remain changed in sensation the next morning you MUST contact your treating dentist and discuss as to whether you have your the root canal or tooth should be removed within 24 hours.


If your injury is more than 4 days old removing the root canal or tooth is unlikely to make much difference to your nerve injury but you can remain on your vitamin supplements and if you are experiencing discomfort and pain you can arrange a consultation with you doctor to discuss prescriptions of Nortriptyline and Pregabalin. Both these medications treat hyperactive or overly sensitive nerves that have been damaged, but they also have many side effects and are contraindicated for some patients.