Question
QUESTION: hi victor,

I am 14 weeks post wizdom tooth extraction and unfortunately have had some massive complications from a seemingly routine procedure which has left me in chronic pain.

My Oral surgeon wasn't to careful in it's extraction and I now have a mandible nerve neuropraxia, which is causing amazing sensitivity in my chin. he is no longer treating me and I am being looked after by the local professor at the university but i wondered whether any TENS treatment or ultrasound in the affected area may stimulate blood flow and un-block areas which are affecting the nerve functioning properly.

I realise nerve injuries take a long time to heal but wondered whether there is anything i can do in the ensuing period which would enable an optimum environment for it.

The drugs i am on have quelled the pain a little which has enabled sleep, but i am constantly feeling fatigues as a result.

Any thoughts would be appreciated.

Kind regards
Steve

ANSWER: Hello, sorry to hear of your pain.

Don't you just love it when a doctor (of any kind, dentist, medical doctor, even a foot doctor, eye doctor, even Chiropractors- like me), uses a phrase 'routine' procedure.  "Routine", small, easy, common, "procedure"- procedure sounds easier than 'surgery',,,,,

Even in my experience as a patient, I have had "routine" "procedures" go awry.  EVERYTHING is easy - -  when someone else is having it done!
Enough soapbox, enough rhetoric.

Mandible nerve: the nerve that supplies our jawbone- the mandible, the lower part of your face, as you said, the chin, and supplies part of the tongue.  You have a left and right mandibular nerve.

Neuropraxia: temporarily irritated/ numb/ sensitive nerve, often from a blow or concussive force. Temporary: a few weeks to a few months at most.

Perhaps even by the time you read this things will be getting better.

Are things getting better- progressing in the correct direction? Are things the same for the last few weeks, are things worse ?

Things should improve, even just on their own.  If things are not improving, go for another opinion, perhaps some testing- to see if this is a neuropraxia or a more permanent, more damaged nerve.

Yes, I do think a regimen of physical therapy could be helpful; ultrasound, electrical trigger point therapy, even use of hot or cold could be helpful.  Depending upon your state laws, the dentist may be able to refer you to a PT who works on head/neck/tmj type cases.  Perhaps your state allows Physical Therapists direct access.  A Doctor of Chiropractic who utilizes physiotherapy in their office could be helpful.

Along with physical modalities to bring down the sensitivity of the nerve, nutritional help could be helpful.  B-complex, calcium and magnesium, of course a multivitamin, omega 3 essential fatty acids, proteolytic enzymes, and lecithin could all be helpful to decrease inflammation and heal the nerve.

You talk about 14 weeks of pain.  This is getting on the long side of what is expected. Begin the nutritional supplements,  Look for PT or DC treatment.  Think about additional evaluation to ascertain if this is a longer lasting nerve problem.  A neurologist could be a good evaluation for this problem if it continues.

As I include with every answer- this information is for educational, discussion purposes only.  Only the treating health professional can make specific evaluation and treatment for you.

Thank you for your time, good luck, I hope for your speedy recovery.

Wishing you, Good Health- Naturally!

Victor Dolan, DC
http://www.DocDolan.net








---------- FOLLOW-UP ----------

QUESTION: Victor,

Thankyou for your informative and witty response....

With respect to 'routine' that comment has been playing in my head since I left seeing the operating surgeon. Every single professional i have seen subsequent that has seen the pre-operative X-Ray has begged to differ.

I think things are getting better which is pleasing. I am already taking a B Complex & B 12 at the moment, and given that I am eating predominantly soft food it involves a lot of other B vitamins folic acid and vitamin C.

Obviously the nerve is inflamed....the professor who is treating me now said it was an 'unroofed mandible nerve' whatever that means.....

One month ago my teeth were sensitive to touch, even the slightest brush of a toothbrush would set them off. Not any more which is pleasing....internally things are getting better - outside the chin sensitivity is an interesting one.

Thanks for listening, hope you had a nice weekend

Steve,
Adelaide Australia


Answer
Hey, thanks for the followup.

You added info seems to say things are slowly progressing in the correct direction.  Thank goodness.

Keep it up with the B-complex, Vit C and Biflavonoids, and add some Omega 3 EFAs and proteolytic enzymes - if you are not doing so already (anti-inflammatory).  And the PT or DC could help with ultrasound perhaps as well.

Good Luck.

Vic Dolan, DC
www.DocDolan.net