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Old 02-13-2008, 07:06 PM   #1
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lingual nerve damage from wisdom tooth extraction

Hi everyone,

Not too sure if this has been talked about before. I'm a 28yo male. I had my two lower and left upper wisdom extracted in 2003 and the lingual nerve was cut. Well sadly the feeling has never came back and it's getting much worse. The original symptoms were burning, numbness tingling feeling (like chewing on foil) The oral surgeon who did the procedure quit his practice two weeks after my extraction and his partner said to give it time and 90% it will heal on it's own

Hmm well today, I have lost taste, a pulling/tugging sensation, no saliva control on the left side on my mouth. It hurts so much right now I cant even brush my teeth on the left side with out putting myself in horrible pain.

I was referred to an maxillofacial surgeon (the only one in Colorado that does nerve repair with the lingual nerve) However, I can not afford the the office visit of $400.00 and my insurance company does not cover any treatment because they consider it cosmetic since it's on the face I thought malpractice insurance covered it but the oral surgeon said they did not since I knew the risk? "confused again", I was never told of any risk or signed any papers stating what the risk were.

To make a ongoing long story short, I just need some help/advise of some sort. I don't know what to do and have considered it's just not worth living with. I'm a very happy energetic person but when you have such a condition that is getting worse all the time and losing your job because you cant to talk to your clients correctly and then foreclosing on your home and losing your car really make me feel worthless... or useless. Thanks for understanding and I feel your pain with anyone else living with this... God Bless

I really hope this is just a bad case of getting screwed and there is some help out there.

Chris

Last edited by tellmem3; 02-13-2008 at 07:12 PM.

 
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Old 02-13-2008, 09:56 PM   #2
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charlottefr HB User
Re: lingual nerve damage from wisdom tooth extraction

oh la la tellmem...if you're looking for people who understand and who will listen to what you are going through or have gone through, then you have come to the right place I am truly sorry that your nerve was cut and that you're suffering from what appears likely to be permanent damage. Now is the time, in my opinion, for you to try to accept this condition and to do what you can, with the support of others, to try to change what is in your power to change! Can you tell that the Serenity Prayer is my mantra?

My lingual nerve was damaged (hopefully not cut) also during a wisdom tooth extraction a month ago and I've been experiencing numbness, etc as a result. There are several threads on here that discuss this problem...and there are many of us who are going through the same thing..and who are hoping that this is not permanent damage for us as well.

There are many things from your post that I'd like to respond to, but my first concern is what you can do right away to help alleviate/lessen the effects of this damage and who could help you learn to cope with this in your daily life? Sadly, I don't think the help will come from the dental profession, from what I've read and experienced personally.

I'm wondering if it would be a good idea to consult a speech pathologist and/or an occupational therapist (since your condition appears to be affecting your work)? I used to work with these types of specialists in my profession..and I know that they can assess a person's disability and can give very practical suggestions on how to cope with your symptoms and how to manage them in your daily social and work life!

Welcome to the board...and please keep posting

Last edited by charlottefr; 02-13-2008 at 09:59 PM.

 
Old 02-14-2008, 09:54 PM   #3
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MaggieMay78 HB User
Re: lingual nerve damage from wisdom tooth extraction

Hi Chris and Charlotte,

I didn't have nerve damage w/my wisdom teeth extractions, but did have some other complications. I won't go into my long story here...but I wanted to chime in about this topic...

One of my friends had nerve damage, and used to go on a very informative message board. I am not allowed to post links here though, sorry But I will say that I read quite a bit on that message board, and my friend shared a lot of info with me. This is what I've learned:

Surgeries to repair nerves generally aren't recommended after six to twleve months post-extraction. Even then, it's risky, and may not result in improvement...but after a year, your chances of improvement are *very* low. Of course, it's still worth seeing a surgeon to confirm this, but I suspect any good surgeon will tell you the same thing...AND keep in mind, there are very few people qualified to do these kinds of nerve repairs!!!
Just b/c they're an oral surgeon doesn't mean they are skilled at this type of surgery...it is VERY different from most other surgeries they perform!!! Again though, seeing an *expert* in nerve repair can't hurt.

That being said, I am wondering if either of you takes medications of any kind? Some people find relief (usually not total relief, but partial) with anti-seizure meds. Yes, it sounds strange, but many anti-seizure meds are also used for nerve pain. Some examples are Neurontin, Trileptal, Lyrica, etc. Another category of meds that is used for nerve pain are the tricyclic anti-depressants (i.e. amitriptyline, nortriptyline, etc). It is a well-known fact that the old tricyclics help many people with nerve pain. Either way, it would be a very good idea to try and get the pain under better control. Even partial relief is certainly better than nothing! However, if you decide to go this route, make sure to find someone that understands nerve pain and will know what doses to give you (and usually, you have to start on a lower dose and then titrate up).

Please hang onto hope!!! I hope this info has been helpful.

Take care,
Meg

Last edited by MaggieMay78; 02-14-2008 at 10:15 PM.

 
Old 02-15-2008, 12:18 AM   #4
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charlottefr HB User
Re: lingual nerve damage from wisdom tooth extraction

Quote:
Originally Posted by MaggieMay78 View Post
That being said, I am wondering if either of you takes medications of any kind? Some people find relief (usually not total relief, but partial) with anti-seizure meds. Yes, it sounds strange, but many anti-seizure meds are also used for nerve pain.....
Hi meg...thanks for the information! I wondered why my family doctor prescribed an anti-depressant for me! Maybe he thought it would help minimize the nerve sensations? I will definitely talk to him about the possibility of trying an anti-seizure type of med. Thank you!

The anti-depressant he prescribed to me is called Laroxyl Roche...and he wrote the prescription after I confirmed that I was having alot of trouble sleeping and probably cos my eyes were filled with tears as I was talking to him..haha. (He had just called my oral surgeon who told him that what I was feeling was 'normal' and I just had to be patient....sigh...the oral surgeon's mantra.) I've only taken the anti-depressant 3 or 4 times and I don't notice much difference except I feel stoned or drunk..both feelings I don't like. I notice no difference in my chin or 'fullness' of my mouth after taking it. If I could find some medication that lessens the almost constant 'activity' and 'tingling' in my chin and lips, I would be very happy.

btw, everything you wrote about surgery to correct nerve damage is what I have read too.....personally, I doubt I will go that route because I just don't want to experience any more surgery if possible. You're right though, it wouldn't hurt to be assessed by a qualified specialist in that area!

Last edited by charlottefr; 02-15-2008 at 12:19 AM.

 
Old 02-15-2008, 10:21 AM   #5
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MaggieMay78 HB User
Re: lingual nerve damage from wisdom tooth extraction

Charlotte,

I didn't recognize the name of the anti-depressant you're taking...so I looked it up, and it turns out that's a brand name for amitriptyline. So yes, amitriptyline IS a tricyclic anti-depressant, and that's good. (Please note: not ALL anti-depressants help w/nerve pain, just the tricyclics and possibly a few others that I'm not sure of..but definitely the tricyclics!) Anyway though, amitrip. is a tricky drug...you have to get the dosing right. Also, it is meant to be taken *consistently* on a daily basis, not just when you have pain. It tends to make people sleepy, and therefore most take it at nighttime.

Generally, with amitrip., you need to start at a lower dose so your body gets used to it, then gradually build up. It doesn't work for everyone, but you have to give it at least a month or so before you give up on it. Not too sure if your family doc knows about proper dosing with it?? Have you discussed that w/him or her?? I took amitriptyline for a few months, but ultimately wasn't able to handle it b/c it made me too sleepy. There is another related drug, nortriptyline, that I hear has less of the drowsy effect.

Good luck, hang in there! Oh, and I was only suggesting a surgical consult if someone would really be willing to have surgery again. Obviously, if that's not you, then it wouldn't make sense to see a surgeon. I was directing that more toward Chris, who I hope we hear from soon!

 
Old 02-15-2008, 10:40 PM   #6
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charlottefr HB User
Re: lingual nerve damage from wisdom tooth extraction

Thank you very much for the info, meg! I didn't know I had to take this daily...so I will give it a try for a month (I started last night). One of the problems I have with going to the doctor, dentist, etc is obviously the language difference. Sometimes I have someone with me who can help translate...sometimes not. I had asked the doctor if I should just take this medicine when I felt pain, and I'm pretty sure he said yes....maybe not He didn't say anything about adjusting the dosage..just that I was to take 4 drops a night followed by a glass of water. He also said I should go back to see him if I have any more problems. My biggest worry is that I don't want to become addicted to any drug to help me deal with life...do you know what I mean?

I hope Chris posts again soon too....I find it very strange that his insurance company considered his problem as a cosmetic one!! My experience with insurance companies is that, sadly, you have to fight and not just accept 'no' as their answer the first time around.

 
Old 02-15-2008, 11:02 PM   #7
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Re: lingual nerve damage from wisdom tooth extraction

Hi Charlotte and Meg,

Thank you for the wonderful information and warm welcome. I tell you, it's mighty hard to live with this stuff. I noticed my nerve pain is worse in times of stress and since all the drama with work, home and car I have been very stressed out.
I have been on quite a few different medications. They range from ultram, vicodin, oxycontin, percocet, amitriptyline, beta blockers. Most of these medications worked very well however not without having bad side effects. The neurologist I've been seeing has determined I have become immune to just about all pain meds and that's most likely why the pain is starting to get worse. I have heard after so many months or years the nerve damage is much harder to fix but I guess it's worth a shot to see what can be done like both of you recommended. Im sure glad I found nice people like you both that do understand and just do not think i'm being all "drama" like my ex-boss stated. I just don't know why the pain is getting worse. One thing I have noticed is my gum where the wisdom tooth was extracted is starting to break down and I'm able to touch the bony surface. Im wondering since this is happening the nerve is getting exposed more and causing more problems. I went to the oral surgeon and he said it looked normal but I think something is going on. Im not sure if there scared that I might sue them or what? First off I don't want to create a law suite of any sort, just looking for some help and possibly some relief.

I am very interested in the Laroxyl Roche that Charlotte is taking. Have you noticed any difference with the nerve pain? I noticed Ultram (tramadol hydrochloride) worked well for a very long time as it had in anti inflammatory and pain reliever in one.

May I mention some of the meds I take are also for degenerative disc / joint disease. The doctors have no idea how that started at such a younger age weighing at 145lbs and an ex lacrosse payer.

Are tricyclic anti-depressants a good thing for nerve repair? Please fill me in on that

I hope to talk to you both very soon and stay connected

Thank you both very much for responding your kind thoughts and advise as it's extremely uplifting. I'll be sure to offer any help/advise to you anytime as we struggle through this.


Chris

Last edited by tellmem3; 02-15-2008 at 11:11 PM.

 
Old 02-16-2008, 12:38 AM   #8
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Re: lingual nerve damage from wisdom tooth extraction

Hi Chris..I'm so glad you posted again I wonder if your ex-boss would change his attitude re: "all drama" if he had to personally experience your symptoms for ohhh...say ten minutes??? My SO recently told me to "stop being a baby" and more or less inferred that I was faking my pain and discomfort. BUT, he would like sympathy/empathy from me for the pain he's now feeling in his knees and he moans and groans when he has to stand up. Go figure Anyway, I've come to accept that I am the only one who can look after me...and I will reach out for help from people who have positive and realistic suggestions for how to deal with this! Like the people on this forum, for example!

I think you are so right about the effects of stress and fatigue on this condition...I have never done so much deep breathing in my life as I have in the last few weeks. One day at a time, I guess....and we have to focus our energy on what's the most important..and let go of the little problems.

I agree that surgery to repair the nerve damage might be 'worth a shot'...but I think it's important to weigh the pros and cons. For myself, I will think long and hard before I let anyone operate on my mouth again. And I'll definitely, in the future, become more informed re: the possible side effects of a procedure.

I am concerned about your gum 'breaking down' or 'deteriorating?' and that you can feel bone there. If your oral surgeon said that 'looks normal'...I just don't understand how that can be 'normal'. Have you thought of going to a different oral surgeon for another opinion?

I'm not sure, but from what you've described previously, in my humble layman's opinion, I think you might have a very good case for a civil suit. Have you spoken to a lawyer about it? It sounds like you may have a permanent condition as a result of this surgery (again, so sorry about that) and if you were not warned about the possible risks or did not sign a waiver that is a very important issue! If the surgeon who did the surgery (and I believe you said he closed his practice 2 weeks later) did something that was not right and you can prove that...I think you might be successful.

Apparently, I was not taking the Laroxyl correctly *insert embarassed icon here* I'm starting to take it everyday now for a month and I'll let you know if I notice any difference. I had just been taking it from time to time before...and it wasn't helping like that so I stopped taking it.

 
Old 02-16-2008, 11:53 AM   #9
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MaggieMay78 HB User
Re: lingual nerve damage from wisdom tooth extraction

Charlotte,

Uumm...you said you're taking "drops" of the medication? Is it in liquid form?? I am confused now. I really think you need to discuss this w/a doctor, as I am NOT a doc myself!!!! I looked it up on the Internet, and it said that the med you're taking is the same as amitriptyline, but now I'm not sure. It could possibly be in liquid form...but I've never heard of that. I took it in pill form...
Anyway, yes, you really need to consult with a knowledgeable doc about this!

I will write more later, am in a rush right now...

Meg

 
Old 02-16-2008, 09:39 PM   #10
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charlottefr HB User
Re: lingual nerve damage from wisdom tooth extraction

Hi meg..yes it's in liquid form..maybe that's unique to France? I don't know. I'm to take four drops every night followed by a glass of water. I got in to see my doctor yesterday and he said the same thing as you re: the nerves. I asked him if there is a chance to become addicted to these meds if I take them everyday. He said yes but not to worry about it.. that if I gradually go off of it, then I should be ok. Btw, he was such a sweetheart yesterday..it was the first time that I felt like someone actually cared. I guess I looked bad enough to rouse some compassion/empathy from him this time...just having come off of a 3 day migraine He actually seemed surprised that I was still numb and in discomfort..and offered to set up the appointment for me with the oral surgeon for a followup...once the OS gets back from holidays

 
Old 02-17-2008, 07:53 PM   #11
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Re: lingual nerve damage from wisdom tooth extraction

Charlotte and Chris,

I have a little more time now, and would like to write a detailed reply, so here goes:

First off, let me explain something about medications: There are BIG misconceptions out there about medications...and even some doctors don't know the difference between the terms I'm about to explain! But if you look all this up online, or in reliable books...you will see that this information is accurate. A board certified pain management doctor will also know this: There is a HUGE difference between *physical dependency* and *psychological addiction.* Let's say you take Oxycontin in controlled-release form daily for a long time (like one of my friends does, as prescribed by her doctor). That is a strong narcotic pain med. Anyway, EVERYONE who takes it, or any similar drug, will become *physically dependent* on the medication. That means that if you stop taking it suddenly, you will indeed experience withdrawal symptoms, such as nausea, vomiting, shaking, chills, etc. Does that automatically mean that you're "addicted" to it?! NOOOO!!! Physical dependency is just your body becoming used to the medication, and being a bit "shocked' (for lack of a better word!) if the med is discontinued suddenly. It's like if some people stop caffeine consumption suddenly after years...their bodies are so used to it, that they may experience headaches, irritability, etc.

The belief that true "addiction" to pain meds is common is the biggest misconception out there. In fact, people that take their medications *as prescribed*...even strong meds, are highly unlikely to become "addicted" to the meds. If you have no history of drug or alcohol abuse, your chances of becoming addicted to medications is something like 1-3%...pretty slim chances. That being said, when I say "addiction", I am referring primarily to psychological addiction, and people taking the meds to escape reality, get "high", etc. These people will do ANYTHING to get more and more of whatever drug they want...and will ruin their lives for it (i.e. lose their jobs, destroy marriages, etc). But these types of behavior are EXTREMELY rare in pain patients that take the meds for legitimate reasons--as I said before, something along the lines of 1-3%. In fact, if taken as prescribed, often in controlled-release form, people should NOT feel high when taking narcotic meds.

Charlotte, as far as worrying about addiction to amitriptyline or any kind of anti-depressant: I wouldn't be concerned at all. Again, if you stop it SUDDENLY, you may experience withdrawal symptoms (i.e. mild nausea w/anti-depressants, usually, maybe trouble sleeping, etc)...but that is just b/c of physical dependency. And they shouldn't be stopped suddenly anyway.

Chris, as far as becoming "immune" to pain meds...that doesn't make any sense. I think the word the doctor is looking for is "tolerant"...and that means (typically) that the dose must be increased. You need to see a pain management doctor that understands these types of problems.

As for the bone problem...I would definitely consider seeking a second opinion from another oral surgeon. Can't hurt!!! Don't let anyone blow you off!!

Hope this has been helpful,

Meg

PS--Some doctors will still be reluctant to prescribe narcotic meds, because the DEA (Drug Enforcement Administration) has threatened doctors that prescribe "too much" of these meds. In some cases, they have even arrested doctors for prescribing these meds!! It is ridiculous in *most* cases...there ARE some docs that are irresponsible in prescribing them, but most are responsible, and it really just ends up hurting pain patients in the end...literally!!

 
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Old 02-17-2008, 11:27 PM   #12
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Re: lingual nerve damage from wisdom tooth extraction

meg, thank you so much for this very informative post and for your support (I read it three times!) I'm learning so much lately re: dental problems and meds which help us cope with them. I guess I am a little paranoid about using anti-depressants or any narcotic drug because my dad was an alcoholic and I know that can be genetic... so I've always tried to be careful in the area of becoming dependent on any drug. I still don't like taking the laroxyl, but I'm determined to give it a good try.

a little positive update: This morning at breakfast, I was able to chew with my lower left molars and they felt almost normal!! I actually stopped in mid-chew and said to myself 'wait a minute, something doesn't feel right here...I'm chewing and it doesn't feel that wierd"... haha. I also started taking Vitamin B12 two days ago...I'm taking it because it's supposed to keep the rest of my nerves "healthy". I guess this will be a lifelong supplement?

 
Old 02-18-2008, 12:26 AM   #13
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Re: lingual nerve damage from wisdom tooth extraction

Charlotte,

Glad that my post was helpful I understand your concerns about drug addiction...but honestly, an anti-depressant is nothing to worry about. The main meds that people worry about "addiction" with are the narcotics/opioids, as well as benzodiazepines like Valium, Ativan, etc... And one thing: when I was making the comparison with caffeine to illustrate physical dependency...I just want to clarify that (obviously) withdrawal from narcotics/opioids is more severe! I'm sure that goes without saying, but just didn't want anyone to misinterpret that. However, once again, if people stop their meds slooowly, the way they are usually supposed to under the guidance of a doctor, then withdrawal shouldn't be unbearable! And as I said, addiction to pain meds among people with no history of drug/alcohol abuse is NOT common.

Anyway...yes, the B-12 supplements are a good idea. I know my friend has a list of supplements she takes for nerve damage; I can ask her about it and get back to you.

I really think that meds are sometimes a "necessary evil" when people are in chronic pain. No one likes to take them long-term, but honestly, I'd rather take medications than have my life destroyed!! My friend has severe chronic pain from a major infection of her jaw bone, as well as nerve damage. She has been taking five different medications for about 4 years now...it's certainly not ideal, but at least she is able to work and maintain some semblance of a "normal" life!! In addition, I take an anti-depressant (for depression) and will probably continue to do so for many years to come. And I suffer from chronic pain...and if I need to eventually take pain meds, then I will. Again, it's not ideal, and there are side effects...but who wants to live in awful pain every day of their lives?! Not me!!!

Last edited by MaggieMay78; 02-18-2008 at 12:30 AM.

 
Old 02-18-2008, 03:02 AM   #14
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Re: lingual nerve damage from wisdom tooth extraction

When you mentioned caffeine addiction earlier, I smiled cos I am definitely addicted to coffee I'll be sure to go off the laroxyl gradually...and thanks for asking your friend about any other supplements that might be helpful!

I certainly have a new respect and admiration for anyone who is living and coping with chronic pain in their body. I have been going through this situation I've been in just for the last few weeks. Luckily, I have never had chronic pain or discomfort before this so it is new to me.

I do have an addiction and that is that I want/need to know why something is happening to me. This morning, I was doing some research on wisdom tooth extractions, lingual nerve damage and numbness and came across a recent study that is very interesting.

According to the Journal of Oral and Maxillofacial Surgery Vol 63, Issue 10, October 2005 pp l443-l446, this retraction of the nerve during wisdom tooth surgery is a 'risk factor' to lingual nerve damage and should be avoided. What is really interesting is that the difference in the control group (which did not have lingual nerve retraction) and the experimental group (which had nerve retraction) was considered to be 'significant'. 9.1% of the experimental group ended up with lingual nerve damage...while none was observed in the control group!

Now I just have to find out what exactly a "lingual nerve retraction" involves and whether or not I had this done during my surgery

Do you (or anyone else?) happen to know what's involved in a "lingual nerve retraction"? I plan to ask my oral surgeon when I go to see him next month and I'd like to know if he used this procedure when extracting my tooth.

Last edited by charlottefr; 02-18-2008 at 03:03 AM.

 
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