Do you need a referral? Have you been injured?
URGENT treatment (within 30 hours) is indicated in endodontic (Root canal) and implant related nerve injuries Contact Us
Referral is recommended based on the cause of injury:
|Endo root canal||> 24-48 hours|
|Implant||> 24-48 hours|
|Wisdom teeth||< 3-6 months|
|LA||> 3-6 months|
|Orthognathic||> 3-6 months|
|Fracture||> 3-6 months|
If you have had surgery or dental treatment and you notice any of the effects listed above after a local anaesthetic should have worn off – say 6 hours later – it is really you seek advice from the surgeon/hospital/dentist.
With any nerve injury you may ask your dentist to prescribe you short term high dose steroids and anti inflammatory medication to minimise inflammation around the damaged nerve or elect to take some Folic acid supplements, but there is no evidence base to support this practise.
Trigeminal Nerve Injuries referral
The trigeminal nerve is the large sensory nerve that supplies feeling to your face, mouth, eyes, nose and scalp. Nerve injury can sometimes result from dental treatments such as dental injections, root canals, insertion of dental implants and removal of teeth or other surgical treatments. These dental injuries affect the trigeminal nerve usually the lower lip or tongue areas— causing a mixture of pain, numbness and strange sensations that may be present all the time or intermittently.
Trigeminal nerve injuries can be extremely distressing for patients. Although the majority of patients regain normal sensation and function within a few weeks or months, some are left with abnormal sensation or pain, which can cause problems with speech and chewing.
Signs and symptoms – What you may be experiencing
Trigeminal nerve injuries can cause episodes of intense, stabbing, electric shock-like pain in the areas of the face where the branches of the trigeminal nerve are distributed — the lips, eyes, nose, scalp, forehead, upper jaw and lower jaw. Sometimes you may notice pain with touch or when a cold breeze hits your face.
Eating, speaking, drinking, brushing your teeth, shaving or applying makeup may all be difficult because of the changes in feeling. Examples of some patients with these nerve injuries.
How to get referred to Kings College Dental Hospital in London
Your dentist or doctor should write a referral letter and post or fax to Tara Renton:
Please mention to your doctor or dentists that the date and cause of your nerve injury must be stated.
If you have had lip nerve injury related to implant treatment or root canal you may need URGENT treatment.
Other types of nerve injuries require less urgent management.
When you go to a clinic, make sure that you have any relevant letters, results of tests and copies of X-rays and scans with you.
Are you having difficulty being referred?
If your dentist or doctor is reluctant to refer, and you are in the London area, you can attend a Dental A&E Walk-In-Clinic at Kings College Hospital, open 9am – 2pm weekdays. A full consultation may not take place until a later date. There may be similiar services in your area; you could Google ‘dental hospital city’, where ‘city’ is the name of your nearest major city to find out whats available near you.
What to expect at a clinic
First of all a clinic will need to make a diagnosis They will need to fully understand your problem and will need to ask you further questions and look through your information. In making a diagnosis of trigeminal nerve injuries, a surgeon may need to examine you. The surgeon will ask about any previous dental procedures that may have caused the condition, as well symptoms you may be experiencing. This information helps to rule out other conditions that cause facial pain, such as diseases of the teeth, gums or jaw.
These tests are used to eliminate some causes of trigeminal neuralgia, such as lesions, aneurysms or multiple sclerosis which are not usually present in patients with nerve injuries.Once all the examination and tests are completed your surgeon will confirm your diagnosis and give you an explanation of what may be possible to help.
Possible treatments include:
- Counselling and cognitive behavioural therapy- the team will likely assess you for individual or group patient sessions.
- Medication for pain sometime tablets sometimes numbing patches. Often you will be referred back to your doctor if medication is needed.
- Surgery is rarely carried out for this condition although this may be discussed with you.
After the consultation we write letters to the person who referred you to us and you are copied in.