Numb tongue after wisdom teeth removal

Have you been told by a surgical specialist that you are at risk for potential nerve damage, commonly referred to as paresthesia, as a result of your wisdom teeth removal procedure? Or have you done some research and heard that paresthesia is a potential wisdom teeth removal complication?

While some patients may be at high risk for paresthesia, other patients will not be at risk for this complication. Why is that? Every individual has a unique anatomy. The way that a person’s roots are in relationship to the nerves and other risk factors associated with the patient’s anatomy will determine whether that person is at risk for paresthesia. Obviously, this type of news can be very scary for a patient to hear, especially if they are experiencing pain from their wisdom teeth and really wants to proceed with removing the wisdom teeth.

If you have been told that you are at risk for this complication, what are some things we can do to minimize any potential complications? Or, if you have already had your wisdom teeth removed and are experiencing paresthesia, what can we do to reduce the numbness of your lip, chin, or tongue? First and foremost, if a patient is at a high risk for paresthesia, we prescribe anti-inflammatory steroids for the patient to start the day prior to their procedure. These steroids will significantly reduce inflammation experienced after the procedure. Essentially, inflammation of the nerve is what causes paresthesia, so it is important to reduce that inflammation and steroids are an excellent way to help prevent that or help address it when a patient has experienced numbness. Another medication that can help is ibuprofen or Aleve, otherwise known as NSAIDS. The reason that we use these is that they are very effective in regards to helping reduce that inflammation. To help reduce the inflammation that is causing numbness and/or pain, we recommend that the patient take these medications as prescribed.

Another technique to reduce inflammation and swelling is to ice the area consistently for a few days after the procedure. This definitely helps reduce inflammation and the swelling that occurs in the nerve due to potential nerve damage.

However, the most important technique that also exists is TIME. Quick story, my fiancé had her wisdom teeth removed back in Toronto about seven years ago. The surgeon discussed the risk of paresthesia with her during the consultation and sure enough, after the removal of her lower wisdom teeth, she had lost sensation in the middle of her lower lip and her chin. The inferior alveolar nerve is a sensory nerve and this is the nerve that was inflamed from the procedure. It took approximately six months to really get that innervation back. To reiterate, the most important thing is to give it time to heal. During my nine years of practice, I have heard stories from patients and their family members who experienced paresthesia when they had their wisdom teeth removed in the past. I have rarely met a patient who experienced permanent paresthesia. In nearly all cases, the paresthesia is temporary. I recall meeting a patient in my second year of practice who came for a dental implant procedure and she mentioned that a few years back she had her wisdom teeth removed and she could not feel her lower lip for about a year and a half. Given enough time for healing, it is highly likely that paresthesia symptoms will resolve on its own.

However, preventing nerve damage is always more ideal than trying to find solutions to treat nerve damage after it has occurred. If your surgeon tells you that you are highly likely to experience some type of nerve damage, but you really need to have your wisdom teeth extracted, there are ways in which nerve damage can be prevented. Rather than dealing with the complications using steroids and NSAIDS or just waiting it out, you can follow these steps to help prevent nerve damage in the first place:

• Utilize a surgical specialist who has plenty of experience removing wisdom teeth from simple to complex cases so that these issues can be foreseen and treated appropriately
• Visit a surgical center that uses 3D technology (such as a cone beam CT scanner) so that the specialist can clearly see where the nerve is in relation to the roots of the teeth and create an extraction plan that takes this into consideration to prevent nerve damage.

These are two very important planning mechanisms that will decrease the likelihood of nerve damage during your wisdom teeth removal.

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Table of Contents

1. When Do You Need to Get Your Tongue Numbed?
2. The Process of Numbing & Different Methods
3. How Long Will It Last?
4. Effects from Numb Tongue
5. Precautions to Take
6. References

Dentists use anesthesia to induce numbness around the mouth and relieve any pain. In some cases, dental practitioners use anesthesia to keep you calm and relaxed.

When Do You Need to Get Your Tongue Numbed?

Your tongue gets numbed as part of the application of anesthesia or the use of sedation. Several procedures and conditions necessitate the need for numbing. For example, dentists use local anesthesia to perform extensive tooth cleaning, root canal treatments and teeth extractions. 

Numbing will also help patients suffering from a variety of maladies that make it difficult for them to stay calm. Their anxiety can hinder the repair process by limiting access to the affected areas.

For example, patients with a strong gag reflex may struggle even with routine dental processes. Similarly, patients with joint pain in their mandibles may also require sedation or an anesthetic to allow their mouths to open up wide enough enough for a dentist’s access.

For more invasive treatments, dentists rely on other extensive forms of anesthesia application or sedation. Such processes include:

• Wisdom teeth removal: Their later emergence means they can often distort teeth arrangement, necessitating removal, which is sometimes difficult and can be traumatic without numbing.
• Dental implants: Dental implants procedures can induce plenty of anxiety, but patients must remain still to enable the dentist to insert these precision implants correctly.
• Emergency dental treatment: In case of a dental emergency, the shock and pain you are experiencing calls for numbing to keep you calm and relieve your current pain.
• Bone grafting: This procedure may be necessary for alignment, especially for those who need to fit dentures properly. Without a tongue numbing, the procedure can be painful – or at least uncomfortable.
• Jaw surgery: Surgery may be necessary to treat conditions like congenital misalignment of the jaw or sleep apnea.

Process of Numbing: Different Methods

There are different ways of numbing, and the choice depends on the patient's condition and the state of consciousness that the doctor will want them in during treatment. The four main options are a topic anesthetic, a local anesthetic, a general anesthetic or sedation.

Topical Anesthetic

The dentist applies a numbing gel to the area that needs numbing. It is usually a way to help with the pain that comes with the needle administering other forms of anesthesia.

Local Anesthetic

The dentist injects the numbing agent into the specific location of the procedure. There are numerous drugs, including lidocaine, but articaine is gaining more popularity for its effectiveness.

General Anesthetic

This is the strongest form of anesthesia, and it will render the patient unconscious. It is rarely used unless it is a major procedure with plenty of pain or the patient is uncontrollable.

Sedation

Sedation, unlike anesthesia, will not leave you completely numb or unconscious. It will help you relax and calm unaware of the procedure. Parts of you may be slightly numb. It can be administered through inhalation, an oral drug or an IV solution.

How Long Will It Last?

How long tongue numbness lasts varies person to person, and it depends on a combination of factors. (Three factors are the method of numbing and the amount and strength of medication used.) On average, though, the during is two to five hours.

A local anesthetic usually falls within the three-to-five-hour bracket, while general anesthetics, which usually leaves you unconscious, can take longer.

As for sedation, inhalation has the shortest acting period, usually between one to two hours. On the other hand, IV sedation will take one to six hours, depending on the amount of sedation used.

Again, people with a fast metabolism will see the numbness wear off faster. For this reason, you are encouraged to be physically active.

Effects from Numb Tongue

There are generally few to no side effects from a numb tongue. What you get are usually general side effects to the numbing agent and  these typically wear off within a short time.

Some of the effects from a numb tongue include:

• Nausea and vomiting
• Itchiness
• Sore throat
• Difficulty in chewing and swallowing
• Burning and tingling sensation
• Some may feel the loss of taste

Precautions to Take

There are a few precautions you should consider when getting a numbing agent for your dental procedure, which includes:

• Allergies: Let the doctor know if you have any allergies to pain killers or any anesthetic agents.
• Age: Children and older people will require dosage adjustments and special consideration to prevent adverse effects from the numbing agents.
• Alcohol: Avoid drinking alcohol at least a day one day before and one day after being numbed. Alcohol can worsen the drug's effect. 
• Medical condition: If you have any pre-existing medical conditions, especially ones that affect your lungs, kidneys, liver and heart, doctors will reconsider the dosages and type of medications they will use.
• Softer foods: Any food you eat should also help prevent hard chewing until the numbness wears off.

References

What You Need to Know About Dental Anesthesia. (December 19, 2019). Healthline.

The 411 On Dental Anesthesia. Colgate.

Guidelines for Use of Sedation and Anesthesia by Dentists. (October 2016). American Dental Association.

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