Implant related nerve injury 


In all cases you MUST let your dentist know about changed nerve sensation the day after your treatment.
It is important for you to understand what type of nerve injury that you have, as they are treated differently and with various degrees of urgency.  In general the earlier nerves are repaired the better the outcome, however, some nerve injuries are best observed over a period of time. 
After surgery where there is a risk of nerve injury during a procedure, your surgeon or their staff should routinely contact you post-surgery the next day. However, this is not yet routine practice for many surgeries.
If you experience a severe / excruciating pain during treatment nerve injury may have happened at this time. Extreme pain after surgery may also be a sign of nerve damage. If your surgeon suspects direct nerve injury during third molar surgery he/ she should immediately refer you to a specialist who may explore and repair your nerve injury urgently.
If you have had a lower jaw dental implant and 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. 
CONTACT your dentist immediately to discuss possible removal of your implant if it is too close to the nerve within 36 hours.
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 implant removed within 24 hours.
If your injury is more than 4 days old removing the implant 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.