Wisdom Teeth
Thursday, December 4, 2008.

Dear Dr. Mady: I recently had all four of my wisdom teeth removed and my lower left side still feels partially frozen or numb. The specialist said this can happen and that it should go away after a while. Is this normal and should I worry? Wayne in Ruthven

Dear Wayne, The condition that you are experiencing is known as Paresthesia and it is always a potential complication or risk of having teeth, especially wisdom teeth, removed. Third molars (wisdom teeth) are often formed in the jaws in a location in which they lie in close proximity to nerves that innervate them and surrounding structures. This is especially common in relation to lower wisdom teeth. Paresthesia usually happens after a difficult tooth extraction, on the same side of the mouth, but it can occur with even a simple, non-troublesome procedure.

Sometimes during the surgical procedure of extracting these wisdom teeth, nerves can be bruised or damaged. As a result, numbness of the tongue, lip, or chin may occur. Paresthesia fells the same as that feeling you get when a dentist uses local anesthetic to freeze you during a procedure. The potency of the numb feeling associated with paresthesia varies depending on the damage to the nerve during the surgery.

Instead of disappearing in a few hours the numbness persists for a longer period of time. In most cases paresthesia is temporary and is resolved on its own within a few days or weeks. In more severe cases the healing process may take several months. If the nerve damage has been significant, the paresthesia may be permanent.

Paresthesia is usually creates situations related to sensory perception rather than motor function. This means that you are most likely experiencing an altered state or loss of sensation or feeling. This mostly involves touch, pain and temperature in the nerve related region. You should not expect to ever experience nerve and muscle interaction problems such as speech difficulties, facial asymmetries and changes, compromised tongue movements, or speech difficulties. Occasionally paresthesia can result in temporary drooling and non-intentional biting of the lip or tongue.

Removal of wisdom teeth at a younger age decreases the chance of developing paresthesia. This is why many dentists and oral surgeons suggest that wisdom teeth be removed when a patient is younger than twenty years of age. The reason for this recommendation is that as we all age and as we move through our twenties the roots of our third molars continue to develop and form, making these teeth more difficult to extract without disturbing adjacent tissues. The incidence of nerve damage from wisdom teeth removal has been reported to run higher after the age of 35, whereas it is rarely occurs for teenagers.

Anyone considering wisdom teeth extractions or who has had them recommended by their dentist, should educate themselves fully before consenting to treatment. Speak to your dentist and/or oral surgeon about all the risks, benefits and alternatives to your recommended treatment and possible unpleasant side effects.

Any questions can be e-mailed to Dr. Mady at drmady@drmady.com

Also visit his new blog at www.dentalden.com (dental education network)

This column is reprinted with the permission of the author and The Windsor Star. "Ask the Dentist" is written by Windsor dentist (and ECDS member), Dr. David Mady Jr.. The column appears the first Thursday of each month in the Windsor Star. Readers with questions can write to "Ask The Dentist", c/o The Windsor Star, 167 Ferry St., Windsor Ontario, N9A 4M5


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