Oral and Maxillofacial Surgeon Questions Impacted Tooth

Risk of nerve damage during impacted wisdom tooth surgery?

I have surgery scheduled next month for 2 impacted wisdom teeth. Is there a risk of any severe long-lasting complications such as nerve damage?

12 Answers


There are always risks associated with this procedure, but these risks are rare and will likely be temporary if nerve injury occurs.
Yes, if they are lower teeth. The risk is typically low, but they should be able to tell how close the teeth are to the nerve with appropriate X-rays. The best way to view that at this time is having a cone beam CT done, which are common in most good oral/maxillofacial offices. They need to balance the risk of the nerve injury with what the risk of NOT taking the teeth out would be.
Although the risk is generally small, there is always a potential for nerve injury with removal of lower wisdom teeth. Without the benefit of seeing the x-ray it is impossible for me to give you an idea of how high that risk may be. One certainty though is that your outcome will be best if the surgery is performed by a board certified oral and maxillofacial surgeon.
There is always a risk of nerve damage, however with careful radiographic evaluation and careful surgical procedure, there is very little risk.
Individual anatomy dictates nerve-root risks related to the inferior alveolar nerve during mandibular wisdom teeth removal. Lingual nerve injury is rare, but is also present during removal of mandibular wisdom teeth. Injury to either of these nerves can be partial or total, and potentially permanent. Evaluation by an oral surgeon can help you better define your risks.
Any surgery has potential risks associated with it. Third molar surgery in no exception. The risks of removing impated third molars on the lower jaw are, pain, swelliing, bleeding, infection, fracture of bone, and damage to the nerve that supplies the feeling to your lower lip and chin. The risk of damage to the nerve is related to the proximity of the nerve to the third molar. A panorex radiograph is the most common way to evaluate the position of the impacted tooth to the nerve. It is then possible to better evaluate the risk of damaging the nerve at surgery. Sometimes a 3D cone beam CAT scan is beneificial in showing the anatomy more clearly. The average of patients who have tingling and numbness after lower third molar removal is in the 0-5% range. Permanent nerve damage is very rare. People can have a numb lip and chin just from having a local anesthetic injected over the nerve for fillings, so it is rare for numbness to persist after surgery lasting for weeks or months. A lot of complication are age realated. The older the patient is, degree of impaction, and the degree of difficluty in the removal, increases the possiblilty of numbness or time it requires for the numbness to go away. Please consult with your Oral Surgeon or dental professional prior to any surgery and have the risk, benefits, and alternatives explained to your completely prior to surgery.
A thorough exam and x-rays by your oral surgeon or dentist can determine if wisdom teeth are indicated to be removed. Indications to remove wisdom teeth include, but are not limited to: infection, gum disease, decay, cyst, and/or crowding. Frequently patients elect to have wisdom teeth removal performed with IV conscious sedation under the care of an oral surgeon.

Any surgical removal has the potential of complications, including but not limited to: infection, pain, delayed healing, numbness to lip/chin and/or tongue, and damage to nearby structures including teeth or sinuses.

Although rare, numbness to the lip, chin and or tongue, possibly including the loss of taste, can follow the removal of lower wisdom teeth. If numbness does occur, if frequently, although not always, resolves or improves within 6 weeks to 3 months.

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As with all surgery, there are risks. These risks should be explained verbally by the treating doctor and specifically detailed on a consent form. With impacted wisdom teeth, the incidence of complications, such as nerve damage, broken jaw, etc., is low, but depends upon the position of the teeth and the experience of the surgeon.
Yes there is, but is very dependent on the relationship of the nerve to the root of the lower tooth. This can usually be told by looking at a panorex x-ray and an experienced Oral Surgery can determine what your approximate chances of incurring nerve injury.
Well, just like anything in life, "it depends". To answer your question, risks for extraction of third molars are pain, bleeding, infection, damage to adjacent teeth, dry socket, sinus infection or nerve damage. Other rare complications are TMJ problems, jaw fracture, jaw infection however quite rare. The prevalence of risk depends on the location of the tooth (upper vs. lower), level of impaction, proximity to sinus or nerve, patient's age, patient's medical history and operative's experience. Hope that helps.
Yes, there is an inherent risk when removing lower wisdom teeth to injury the sensory nerve which supplies the lower lip, chin,gums and or tongue. The risk is usually low but dependent upon anatomical variation. Your surgeon can review your X-rays and advise you of your specific risk.
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