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This is especially addressed to Noreenmachine (but I would like to get feedback on this from others ),
You may have a condition called "paresthesia"/"persistent anesthesia" also known in layman terms as feeling "numb" or "frozen". It feels like tingling, pringling or feelings of warmth, coldness or pressure. It is usually the result of a traumatic event to the nerve. The nerve gets irritated which results in the classical signs of inflammatory reactions...edema and an increased pressure on the nerve. Improper insertion of the syringe while doing a mandibular nerve block is one of the prevalent etiological factors ( as far as I understand). Did you have any wisdom teeth extracted during that appointment?
Paresthesias can be of a temporary or permanent nature. If it lasts longer than 6 months it is usually considered permanent
. There is some dispute ( as there seems to be in every issue in dentistry ) as to how to approach the treatment of paresthesia. Some practitionners advocate the short term administration of prednisone/steroids ASAP as this will diminish the inflammation which is believed to be implicated in the nerve damage. In the extreme cases, I think that there are microsurgical means of repairing the nerve. It is of outmost importance to treat the nerve ASAP once it has been determined to be permanently damaged because the sooner it is treated, the better the prognosis.
If I had a case of paresthesia, I would not consult a general dentist ( sorry, no offence GPs!!! ) but an oral surgeon to follow the course of paresthesia. How is paresthesia monitored? Well, I personally observed a case which was being handled by an oral surgeon while I was a dental student. The patient in question had damage of the inferior alveolar nerve. (Aside ...always always , mention the risk of mandibular nerve damage when extracting wisdom teeth no matter how minimal the risk!) The surgeon performed a "two point discrimination " test ( which I won't elaborate on here
- you can refer to your neuroscience or physiology courses for this) and touch localization to determine the degree of sensitivity of the affected dermatome. Like many neurological conditions, one always has to compare between analogous sites on the two sides of the body . You should also draw a picture of the face in your chart to sketch the damaged areas so that you have something to compare with for future reference. Again, as a general dentist, I think it is better handled by the experienced hands of an oral surgeon or a neurologist.
Any dentists out there who have handled paresthesia cases? How did you treat them? Did you refer?
Good luck, noreenmachine!
You may have a condition called "paresthesia"/"persistent anesthesia" also known in layman terms as feeling "numb" or "frozen". It feels like tingling, pringling or feelings of warmth, coldness or pressure. It is usually the result of a traumatic event to the nerve. The nerve gets irritated which results in the classical signs of inflammatory reactions...edema and an increased pressure on the nerve. Improper insertion of the syringe while doing a mandibular nerve block is one of the prevalent etiological factors ( as far as I understand). Did you have any wisdom teeth extracted during that appointment?
Paresthesias can be of a temporary or permanent nature. If it lasts longer than 6 months it is usually considered permanent
. There is some dispute ( as there seems to be in every issue in dentistry ) as to how to approach the treatment of paresthesia. Some practitionners advocate the short term administration of prednisone/steroids ASAP as this will diminish the inflammation which is believed to be implicated in the nerve damage. In the extreme cases, I think that there are microsurgical means of repairing the nerve. It is of outmost importance to treat the nerve ASAP once it has been determined to be permanently damaged because the sooner it is treated, the better the prognosis.If I had a case of paresthesia, I would not consult a general dentist ( sorry, no offence GPs!!! ) but an oral surgeon to follow the course of paresthesia. How is paresthesia monitored? Well, I personally observed a case which was being handled by an oral surgeon while I was a dental student. The patient in question had damage of the inferior alveolar nerve. (Aside ...always always , mention the risk of mandibular nerve damage when extracting wisdom teeth no matter how minimal the risk!) The surgeon performed a "two point discrimination " test ( which I won't elaborate on here
- you can refer to your neuroscience or physiology courses for this) and touch localization to determine the degree of sensitivity of the affected dermatome. Like many neurological conditions, one always has to compare between analogous sites on the two sides of the body . You should also draw a picture of the face in your chart to sketch the damaged areas so that you have something to compare with for future reference. Again, as a general dentist, I think it is better handled by the experienced hands of an oral surgeon or a neurologist. Any dentists out there who have handled paresthesia cases? How did you treat them? Did you refer?
Good luck, noreenmachine!
