Question

Six months ago I had to have a wisdom tooth removed. Unfortunately, I could no longer feel my lips after the operation. They're a little better now, but they still tingle. My lips are very dry and chapped. I have the feeling that there is also something wrong with my salivation. The surgeon said I should be patient. What can I do to help the nerve regenerate? Massage? Homeopathy? - C. B. in E.

Short answer

A nerve runs in a channel in the lower jaw bone on the right and left, which is responsible for sensation in the area of the respective side of the jaw (teeth, gums) and the lower lip. If the function of this nerve fails, there is a loss of sensation or a disturbance of perception (tingling, hypersensitivity) in the corresponding supply area. The wisdom teeth in the lower jaw are sometimes very close to the bone canal of the mandibular nerve. For this reason, an X-ray is required before each tooth removal to show the course of the nerve and the position of the tooth in relation to each other. In critical cases, it is necessary to produce a sectional X-ray (e.g. volume tomogram) that shows the exact relationship of the nerve to the roots of the tooth. If there is a high probability that the nerve will be injured during tooth removal, the necessity of tooth removal and the risk of nerve loss must be weighed up in advance.

Risk of injury

The latest study by the University of Basel clearly shows that nerve injuries occur very rarely during the removal of wisdom teeth: In 2384 extractions, injury to the mandibular nerve occurred in 17 cases. In all patients, the temporary numbness or loss of sensation returned to normal. Many studies also show that the risk of nerve injury is lowest between the ages of 17 and 24. It is therefore advisable, if necessary, to remove the wisdom teeth before the age of 25. 

Dry lips

 Your injured nerve does not supply any salivary glands. Therefore, the flow of saliva has not been altered by this injury. The flow of saliva is partly controlled by nerve fibers that run together with the lingual nerve. This nerve is also located close to the wisdom teeth. Theoretically, it is possible that some of these nerve fibers were also damaged during the operation. This could reduce the amount of saliva. However, the risk of injury to the lingual nerve is much lower. In the above-mentioned study, an injury occurred in 0.2 percent of cases. Such an injury is unlikely in your case, as you do not describe any changes in sensation in the tongue.

Promoting healing

You will slowly regain feeling and it will most likely return to normal. Patience is advised, as nerve healing takes place very slowly. You can support this process by taking vitamin B tablets daily. You may be able to reduce the tingling with the prescription nerve medication Neurontin. Promoting the healing process with alternative medical measures is possible, but has not been proven.

Author: Dr. med. dent. Jürg Eppenberger
Published in: Neue Luzerner Zeitung on March 16, 2005