For almost everyone, dental treatment is a kind of test. There are risks of developing complications after an incorrectly installed filling or a poorly extracted tooth. There is also the possibility of undesirable consequences from the anesthetic injection. Local anesthesia is almost always used: treatment of deep carious cavities, pulpitis, periodontitis, tooth extraction, prosthetics, implantation, etc. If numbness after an injection does not go away for quite a long time, you need to identify the causes and find ways to eliminate the disease.
How long does it take for a painkiller injection to wear off?
Dentists use several types of anesthesia:
- Applique. An anesthetic in the form of a gel or ointment is applied to the desired area of the gum.
- Conductor. Administered by injection.
- Infiltration. Three-stage anesthesia is usually performed before complex manipulations.
After treatment or tooth extraction, depending on the type of anesthesia, a feeling of numbness remains. If pain relief was carried out correctly, without violating the technology of administering the anesthetic, the numbness goes away after some time.
Experts have identified maximum thresholds for each type of anesthesia:
- after application with gel or ointment, numbness disappears in no more than thirty minutes;
- after conduction anesthesia, the numbing effect lasts up to five to six hours;
- after infiltration anesthesia, numbness disappears within three to four hours.
In order to identify the maximum time threshold, it is also necessary to take into account the individual characteristics of each patient: age, weight, etc.
Treatment
With minor damage, the tissue will go numb until the nerve fibers are restored. This may take several months or up to six months. The doctor will decide whether surgical intervention is necessary or will allow time for regeneration by the body’s natural forces.
Treatment of prolonged numbness after dental implantation, after diagnosing and determining the degree of damage, is prescribed by the implantologist or dentist who performed the operation, and this also falls within the competence of the neurologist.
Drug therapy paired with physiotherapy can quickly restore the conductivity and integrity of nerve fibers. The doctor may prescribe UHF, laser therapy, electrophoresis. From pharmacological drugs: non-steroidal anti-inflammatory drugs, corticosteroids, antibiotics (to avoid infection).
Sometimes it is necessary to remove the implant that caused the disease. Or just unscrew it a little, changing the compression, which could cause such consequences. Microsurgery is rarely used to restore the integrity of nerve tissue. Usually a 12-week wait is given; if medications and physiotherapy do not help, the patient is referred to a microsurgeon. In any case, all actions will be aimed at restoring sensitivity and restoring a person’s normal life.
Possible complications
The human factor plays a huge role in all dental procedures, including the administration of anesthetic.
Complications that may occur after local anesthesia:
- Unpleasant sensations in the injection area. Injecting the medicine too quickly or too slowly may cause pain.
- Hematoma at the site of needle insertion. The formation of a hematoma indicates problems with blood vessels or that the injection site was chosen incorrectly.
- Allergy. An allergic reaction to one or even several components of an anesthetic.
- Inflammatory process, development of infection. This is possible if errors were made during the administration of the anesthetic, due to which microbes penetrated the soft periodontal tissues and caused inflammation.
- Numbness of the facial muscles. The patient cannot control his facial expressions and cannot close his lips.
Why does paresthesia occur?
Decreased sensitivity in various parts of the body is called paresthesia. In dentistry, this pathological condition is associated with nerve damage.
Numbness after tooth extraction most often occurs if a wisdom tooth has been removed. This is due to the fact that the roots of the “eights” are located close to the nerve, which can be damaged due to:
- Traumatic tooth extraction (with its abnormal structure).
- Compression due to postoperative tissue swelling.
- Inaccurate actions of the dentist when administering an anesthetic.
Paresthesia most often occurs in patients over 25 years of age. Other factors that increase the risk of developing pathology include:
- history of neuralgia;
- cardiovascular pathologies;
- diseases of the endocrine system (including diabetes mellitus);
- lack of vitamins and minerals in the body;
- weak immunity.
Signs and symptoms
Complications after tooth extraction are indicated by long-term symptoms that persist for a week or more:
- Lack of sensitivity in a certain area of the face.
- Numbness of the tongue.
- Burning and tingling.
- Weakness of the jaw, inability to close the teeth completely.
- Partial or complete loss of taste.
- Increased salivation.
Symptoms and causes of numbness after an injection
Numbness of the jaw after anesthesia is considered normal. But if it is accompanied by the following symptoms, you should seek the help of a doctor:
- numbness, burning or tingling of the tongue;
- numbness of the cheek;
- painful sensations in the tooth;
- sagging of the lower parts of the face;
- excessive salivation;
- pulsation in the gum.
Factors that influence the occurrence of symptoms:
- when injecting the anesthetic, the needle entered a blood vessel;
- a nerve was damaged during the injection;
- due to increased toxicity, the anesthetic itself caused numbness.
Prevention
Before going to see a dentist for treatment or tooth extraction, you should follow a few simple rules that will help you undergo the intervention without further complications:
- do not drink alcoholic beverages (at least 2 weeks before anesthesia);
- monitor blood sugar and blood pressure levels;
- limit the amount of liquid you drink.
As a rule, numbness after anesthesia goes away within the prescribed time. Complications occur together with other symptoms that are difficult to ignore.
Category: Tooth extraction Published by Mister stomatolog
Computer anesthesia
In order to eliminate the possibility of developing complications after an injection, modern dentistry uses computer anesthesia.
Advantages of the technique:
- There is no numbness of soft tissues. Computer anesthesia only numbs the area where the anesthetic is injected.
- Computer anesthesia is painless.
- The pressure of the anesthetic is controlled by a computer, so it is administered at the desired speed and in smaller quantities.
- There is no feeling of gum swelling.
- The influence of the human factor is eliminated due to the fact that the computer controls the entire process.
- The tip is shaped like a pen, which is less intimidating for patients who are afraid of injections.
Complications of local anesthesia and endodontic treatment
Posted by Tara Renton
Translation: Gavryushina Anna
Possible mechanism of nerve damage during local anesthesia
Nerve injury due to local anesthesia is a complex problem. Nerve damage may be physical (needle, compression due to epineural or perineural hemorrhage) or chemical (bleeding or local anesthetic components). Thus, the resulting nerve injury may be a combination of peri-, epi-, and intraneural trauma causing subsequent hemorrhage, inflammation, and scarring leading to demyelination (loss of the nerve sheath). Administration of local anesthesia can cause nerve damage in a variety of ways. The location of the nerve injury may also be important, as well as the mechanism. Factors to consider are that only 1.3–8.6% of patients experience an "electric shock" type sensation when receiving mandibular anesthesia, and 57% of patients who suffer from long-term neuropathy did not experience discomfort during the injection , so this is not a specific sign.
Injuries during mandibular anesthesia
Neuropathy
Any damage to sensory nerve tissue can cause a combination of anesthesia (numbness), paresthesia (altered sensation that is not painful), dysesthesia (altered sensation that is unpleasant/painful), and neuropathic pain. Neuropathy in the orofacial region should be taken seriously and the cause should be determined as there are some serious conditions that need to be addressed if the cause is not obvious. It is often possible to determine its origin from the anamnesis. Lack of sensation must be noted on the face so that the increase or decrease in the insensitive area can be assessed. Any patient with an expanding area of paresthesia for which there is no known cause should be referred to a specialist. Among other things, paresthesia can result from trauma, nerve damage, surgery, infections and prolonged reactions to local anesthesia, viruses, malignancies, or serious illnesses. If a dental cause is suspected, patients require re-evaluation, careful documentation, and follow-up.
Unilateral paresthesia and facial paralysis can occur when conduction anesthesia is administered in the wrong direction when the local anesthetic solution is deposited in the parotid gland. This usually occurs when the depth of penetration of a long needle is approximately half its length. This most likely occurs when the mandibular ramus expands laterally, making it difficult for the operator to “feel the bone.” Unilateral facial paralysis is reversible. It goes away within a few hours. The patient should be reassured and his eyes protected until the blink reflex is restored, as the corneal reflex is often impaired.
Neurological damage from untreated periapical infections
In endodontic practice, we often encounter patients with apical periodontitis of endodontic origin, leading to impaired sensitivity of the inferior alveolar or mental nerve. It invariably resolves with a decrease in inflammation and local swelling. A number of authors have reviewed and documented clinical cases of a neurological disorder with paresthesia and hypoesthesia of the mental nerve arising as a consequence of apical periodontitis of the second premolar and second molar of the mandible.
Motor nerve palsy due to endodontic treatment
There are reports of shortages
Diagnosis and treatment
If numbness of the cheek or lip does not go away for a long time after tooth extraction, you need to undergo diagnostics - as a rule, such equipment is available from a neurologist. Most often, ENMG (electroneuromyography) is prescribed at the level of the facial and trigeminal nerves. Based on the results of the analysis, the type of neuropathy[1] is identified and appropriate treatment is prescribed, which can be of the following types:
- conservative (taking medications): B vitamins are prescribed (in tablets), less often - injections,
- massage of the area to which perception has not returned,
- physiotherapy: electrophoresis, magnet,
- surgical treatment: restoration of the integrity of the nerve through surgery.
“It took me a long time to recover the sensitivity of my cheek after my wisdom tooth was removed. It was very unpleasant not to feel part of my face; because of this, I constantly bit my cheek. I tried to do a massage, but it didn’t really help. Then I went to a neurologist and was prescribed vitamins. It was from them that the effect slowly began to appear. After about a month everything became fine.”
Julia P., review from otzovik.com
