13
   

Can someone give me hope?

 
 
Reply Fri 9 Nov, 2012 05:49 am
The story:

During my wisdom teeth extraction, I woke up and the anesthesia wore off so I was in a lot of pain. I was screaming and crying and trembling. After surgery, I confronted him about it and he just told me that the surgery was a complete success and that I didn't wake up throughout the entire surgery and that he did not touch the nerve. I dropped it.

Now, 1 week later, I still can't feel a portion of my face (see picture). I called yesterday, but he didn't pick up, so I'll try calling again today. My sister works in the hospital and she asked an oral surgeon about it and he said he'd check me out, but that he didn't want to tell me anything until he was sure. I set up the appointment.

http://i.imgur.com/1YDLR.gif

Conclusion:

So, I know I'll get my answers eventually, but being left in the dark is torturing me. Can anyone give me some words full of hope to get me through this?

 
jespah
 
  1  
Reply Fri 9 Nov, 2012 07:19 am
@PinkLipstick,
I had abdominal surgery 2 years ago. I know it's not the same body part, but please hear me out just the same.

Pain, yes, whew doggie. Not fun. And definitely some losses of sensation. See, nerve endings do get cut or damaged. They don't mean to do it. But if they're taking a chunk of you out, it's kinda sorta inevitable. I am not saying they are lying to you. And God knows I am no doctor. But pain is still rather misunderstood as a biological mechanism.

Anyway, to make a long story only slightly longer, I still have some loss of sensation issues but no pain. If I get ab pain from situps, it's from situps and not the surgery. In January, it'll be 3 years since my surgery.

As they say, this, too, shall pass.

In the meantime, consider that the surgery was necessary and you're already through with that part.
PinkLipstick
 
  1  
Reply Fri 9 Nov, 2012 07:57 am
@jespah,
Did you wake up during the surgery too? Is it normal? When I woke up, it hurt a lot, so I jerked and had this uncontrollable tremble, so I'm scared that might have messed up the doctor and something might have accidentally been cut.
jespah
 
  1  
Reply Fri 9 Nov, 2012 08:20 am
@PinkLipstick,
I don't recall waking during that particular surgery, but I've had oral surgeries where I've been kind of half-awake (they do that so they can get you to open wider or whatever) and it is definitely scary. I think that's kinda normal, being a bit scared and disoriented. See, I never want to know what they're doing. I just want to know that they're done, and it worked.
PinkLipstick
 
  1  
Reply Mon 12 Nov, 2012 12:01 am
@jespah,
The anesthesia wore off, though. It hurt immensely!
hawkeye10
 
  1  
Reply Mon 12 Nov, 2012 12:14 am
@PinkLipstick,
you are lucky that anyone will see you. normally docs dont want to get involved in other docs potential malpractice cases.

wait....you are not in America are you.....i have had a long day, slow to figure this out.
jespah
 
  1  
Reply Mon 12 Nov, 2012 07:23 am
@PinkLipstick,
I know - it definitely hurts. How are ya feeling now? Any better?
PinkLipstick
 
  1  
Reply Tue 13 Nov, 2012 04:27 pm
@hawkeye10,
I am in America.

When everything happened, I talked to my sister about it, and then when she went to work at the hospital, she went to talk to the oral surgeon and told him what happened. Then he said that he'd see me and gave me his next available appointment.

0 Replies
 
PinkLipstick
 
  1  
Reply Tue 13 Nov, 2012 04:39 pm
@jespah,
But I wasn't supposed to wake up in the middle of the surgery. I was supposed to be given enough anesthesia to sleep throughout the entire procedure. When I woke up, the doctor was shocked.

Even if I woke up during the surgery, it would've been fine. I wouldn't have cared so much. But the numbing wore off as well in the middle of the surgery and I felt the pain as he cut my gums and pulled out my wisdom teeth.

Dear god, I don't think I've ever screamed so loud or cried so much or trembled so violently...

The next day, I confronted him about it and he gave me the run around. It went like so:

Me: "Why did I wake up in the middle of surgery?"
Doc: "Yes, you didn't wake up at all during the surgery!"
Me: "I woke up during the surgery, remember? You wiped the tears from my face."
Doc: "Yes, you didn't wake up during the surgery."

I figured it was pointless to argue with him, so I dropped it. But I still can't feel my face 1 week and 4 days later! I tried calling him and he won't pick up the phone. My appointment with the oral surgeon isn't for another week, so I really want to talk to the guys who originally did my surgery. I'm going to go to his office personally tomorrow, since he won't answer me.
0 Replies
 
firefly
 
  3  
Reply Tue 13 Nov, 2012 08:52 pm
@PinkLipstick,
I found this on the internet and it seems to describe your situation.
Quote:

Numbness After 3 Weeks After Wisdom Teeth Extraction, What Should I do?

I had 2 wisdom teeth extracted (a tooth on each side of my lower jaw) 3weeks ago. On left side of my face, I feel numb on by lower lip and chin but have occasional tingling sensation and itches. I went back to my surgeon and she placed on Vitamins B1, B6, B12. I need a second opinion from Doctors. Please advice.
--------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------
Responses from 2 dentists...

Numbness after wisdom tooth removal. Rare but possible.
Looks like you are experiencing what is called paresthesia. Paresthesia is an altered feeling or sensation to an area. Anesthesia is total numbness/ no feeling. The mandibular nerve probable got irritated/ inflamed or bruised during the procedure (a known risk/ usually quite rare). The fact that you are experiencing tingling is a good sign that the nerve may be on it's way back to healing after the injury. We have seen this last for as little as a few days and for as long as 6-12 months, and in very rare cases never returns to normal.

You may consider having an evaluation by an Oral Surgeon who specializes in Mandibular nerve repair just so that you have all your options laid out.

Hope this helps. WIsh you a speedy recovery!

Giri Palaniswamy, DDS
Beverly Hills Cosmetic Dentist

Numbness after extraction of wisdom tooth

Numbness following the extraction of a lower wisdom tooth is a well known risk of that type of surgery. It very often can take anywhere from a few weeks to a few months to return to normal. Occasionally, it never returns to normal. It all has to do with the trauma to your mandibular nerve which lies in your jaw very close to the roots of the wisdom tooth. If that nerve is totally severed, the feeling may never return to your jaw. More often than not, however, there might have been a slight "bruising" of the nerve or simply extreme inflamation, in which case the feeling usually does return. Only time will tell. Be patient.

Jay Neuhaus, DDS
New York Cosmetic Dentist
www.gramercydentalarts.com

http://www.realself.com/question/numbness-after-wisdom-teeth-extraction1


Consulting another oral surgeon is a good idea, and so is the advice to be patient. The fact you still have the numbness a week and a half after the extractions may simply mean that the possible trauma to the mandibular nerve hasn't had enough time to heal.

From the responses of the two dentists given above it seems the problem is related to the proximity of the mandibular nerve to the roots of the wisdom teeth, and may have little or nothing to do with your possible awakening during the surgery and moving.

I found another article for you that says pretty much the same thing.
Quote:
Tooth-extraction complications - Oral paresthesia (nerve damage).

Oral-surgery
complications.

What is oral paresthesia?

One of the potential complications associated with wisdom tooth removal is paresthesia. Paresthesia refers to a situation where postoperatively a patient experiences altered sensation due to nerve trauma or damage sustained during their oral surgery.

Why does it happen?

In regards to wisdom tooth extractions, a patient's risk for experiencing paresthesia is related to the positional relationship between their tooth its associated nerves.

If a nerve lies in relative close proximity to the tooth (or close to or in the tissues around the tooth that must be manipulated during the extraction process) then there is potential that it may become bruised or damaged during their surgery.

Which nerves are typically affected?

The nerves that typically placed at greatest risk during wisdom tooth removal are the mandibular and lingual nerves.

The mandibular nerve runs within the lower jaw (both right and left half), in the neighborhood of the tip of the roots of the lower teeth. It then ultimately branches out and runs to the lip and chin.

The lingual nerve, actually a branch of the mandibular nerve, runs in the soft tissue on the tongue side of the lower jaw and ultimately courses on to the tongue.

What does having paresthesia feel like?

Usually paresthesia is a strictly "sensory" phenomenon. The person experiences a loss of sensation (touch, pain, proprioception, temperature or taste) it is not accompanied by any type of paralysis.

For most people, the sensation of having paresthesia is similar to what they experience when they have a tooth "numbed up" with anesthetic ("novocaine"). The difference being that the sensation persists. In most cases, the area affected by the paresthesia is the person's lip, chin or tongue (the tissues innervated by the mandibular and lingual nerves).

How long does paresthesia last?

Fortunately, in most cases a person's paresthesia will resolve on its own after just a few days or weeks. However, there can be cases where a person's paresthesia can be classified as being "persistent" (lasting longer than 6 months). In a small number of cases, a person's paresthesia can be permanent.

--------------------------------------------------------------------------------

Risk factors for wisdom tooth-related paresthesia.

A) Location, location, location.

Studies have shown that the risk of experiencing paresthesia is greatly dependent upon the specific tooth being extracted and its particular anatomical positioning. Lower wisdom teeth are much more likely to be associated with paresthesia than upper ones (due to their close proximity to the mandibular and lingual nerves).

Lower full-bony impactions are the type of extraction most likely to be associated with a risk of paresthesia of the mandibular nerve. Any lower wisdom tooth angled or positioned relatively closer to the tongue-side of the jawbone places the lingual nerve at greater risk for trauma during surgery.

B) Surgical factors.

Research has demonstrated that the practitioner's experience, the surgical technique they use, and the overall duration of the extraction process all play a role in how much risk exists for any one patient to experience paresthesia. This is one reason why many dentists will choose to refer potentially challenging wisdom tooth extractions to an oral surgeon.

C) Age can be a risk factor for paresthesia.

After the age of 25 years, a person's risk for experiencing paresthesia typically increases. Relatively "older" patients (those over the age of 25 years and especially over the age of 35 years) typically have more completely formed wisdom tooth roots and denser surrounding bone. Both of these factors increase the difficulty of performing the tooth's extraction without disturbing its surrounding tissues.

A risk for paresethesia can be one reason why asymptomatic full-bony impacted wisdom teeth that show no sign of associated pathology are often left alone in people over the age of 35 years.

--------------------------------------------------------------------------------
How likely is it a person will experience paresthesia after a third molar extraction?

A literature review performed by Blondeau (2007) found reported rates for paresthesia after wisdom tooth removal ranging from 0.4% and 8.4%. A large study involving the extraction of over 8,000 third molars (Haug 2005) found an incidence rate of less than 2% in a study group of patients age 25 years and older (a group expected to be at relatively at-risk for paresthesia).

How long can paresthesia be expected to last?

In most cases, a patient's paresthesia will resolve on it's own over time. This can, however, can take several months to over a year. In some cases, a person's paresthesia is permanent.

Most recoveries take place within the first 3 months after the person's wisdom tooth extraction. At 6 months, one-half of all of those affected experience a full recovery (Queral-Godoy, 2005).

Persistent paresthesia is typically classified as altered sensation that lasts longer than 6 months. Pogrel's (2007) review of dental literature reported an incidence rate of persistent paresthesia ranging between 0% and 0.9% for the mandibular nerve and 0% and 0.5% for the lingual nerve. (These numbers aren't for those populations who experienced paresthesia but instead a percentage of all people who had a wisdom tooth extracted.)

If paresthesia persists, is treatment possible?

For those who experience persistent paresthesia, it may be possible to attempt some type of surgical repair. In most cases, this approach is not taken until 6 to 12 months after the original injury (it can be performed even later). The reported results for surgical intervention (Pogrel, 2007) vary widely. Success rates appear to range between 50% and 92%. These successes, however, are typically stated in terms such as "produced some recovery."
http://www.animated-teeth.com/wisdom_teeth/t7-wisdom-tooth-paresthesia.htm

Hopefully, given some more time, the numbness will go away on its own.

But, I am curious that, if you did awaken during the procedure, why wouldn't the dentist just have given you more anesthesia? Why would he want you awake and in pain? How could he have even completed the procedure if you were screaming, crying, and moving? It doesn't quite make sense to me. Are you very sure you were awake and not dreaming, or in a dream-like state after the extractions as the anesthesia wore off? There is a great deal of pain after wisdom teeth are removed--even though I had it done decades ago I still remember the pain afterward once the local injections wore off. If you began feeling the pain as the anesthesia wore off, but you weren't yet fully conscious, you might have imgined the dentist was still removing the teeth. Just a thought.
PinkLipstick
 
  2  
Reply Tue 13 Nov, 2012 09:13 pm
@firefly,
Hmm, but I haven't been having the tingling sensation at all in all this time, so I'm a bit worried. Also, the dentist said he didn't touch the nerve at all. He said he saw it, but didn't touch it.
firefly
 
  2  
Reply Tue 13 Nov, 2012 09:31 pm
@PinkLipstick,
I don't think they have to touch the nerve to "bruise" or traumatize it--it's that the nerve is close to the roots of the wisdom teeth and it can be irritated or inflamed by the movement of the wisdom teeth as they are being extracted.

From the longer article I posted for you, it sounds like a week and a half isn't a very long time for this sort of paresthesia to persist--that doesn't indicate that it won't go away, on its own, after a bit more time. And you don't necessarily have to experience a tingling sensation.

I found this comment from another dentist.
Quote:
After the wisdom teeth are extracted, a patient can expect some pain or discomfort normally responsive to pain-medication, minor bleeding, puffiness in the face and jaw areas, and temporary (and in rare cases permanent) loss of sensation in the lower jaw due to damage of the inferior alveolar nerve that provides feeling to the lower lip and chin.
http://myoremdentist.com/dental-library/wisdom-teeth.php

It's good you'll get another opinion from the oral surgeon you'll be seeing. Until then, try to be patient and try not to worry too much. The probability is the loss of sensation in your face is only temporary.
0 Replies
 
ossobuco
 
  1  
Reply Tue 13 Nov, 2012 10:03 pm
Good research, firefly.

I'll add in passing that I did wake up in my second breast cancer lumpectomy, felt scraping going on. It wasn't horrible, just 'out of place'. I said ouch, heard myself say it, and I was back under within milliseconds - I know at least in that situation the anesthesiologist is keeping the drug level as low as possible to do the job.

I'm an odd patient in that I wanted at one point to be a surgeon and that present surgeon was a very well regarded one. She had gone in a second time since she wanted to be sure to get "clear margins". Operating rooms don't scare me, I'm actually interested. That was more than ten years ago, I'm fine, and I think both the anesthetist and the surgeon were pros. Just answering because I did experience waking up in surgery.


PinkLipstick
 
  1  
Reply Wed 14 Nov, 2012 03:18 am
@firefly,
Quote:
But, I am curious that, if you did awaken during the procedure, why wouldn't the dentist just have given you more anesthesia? Why would he want you awake and in pain? How could he have even completed the procedure if you were screaming, crying, and moving? It doesn't quite make sense to me. Are you very sure you were awake and not dreaming, or in a dream-like state after the extractions as the anesthesia wore off? There is a great deal of pain after wisdom teeth are removed--even though I had it done decades ago I still remember the pain afterward once the local injections wore off. If you began feeling the pain as the anesthesia wore off, but you weren't yet fully conscious, you might have imgined the dentist was still removing the teeth. Just a thought.


My mother was there when it happened. She heard me screaming and wanted to go in but they wouldn't let her. After I woke up, I stayed awake, so when the surgeon was done, he removed the pink napkin from over my face and wiped my tears away and then my mom rushed in and took me away.

And yes, after I woke up, he suddenly rushed around to get something that would help with the pain. Then he injected me with novacaine, but that didn't help much.

After that, he told be to "please be quiet" that he "can't concentrate." so I bore through it since I didn't want him to mess up.

Anyways, isn't an anesthesiologist supposed to give you things to make you go to sleep before surgery? The person who made mine was some pretty young blonde chick that answered the phones and made appointments. She mixed some stuff in a small plastic cup and poured a bunch of sugar into it, then she told me to drink it, and that's the only thing they gave me to put me to sleep.

Also, I was there for 4 hours in total, and my mom said that a few hours passed before the doctor started the surgery on me, which is probably why by the time he did it, whatever was given to me had worn off.

Also, shouldn't a surgeon have done my surgery in a hospital and not a dentist in his private clinic with the lady who answers phone calls?
mags314772
 
  1  
Reply Wed 14 Nov, 2012 07:42 am
@ossobuco,
I recently had a cardiac procedure to implant a new ICD. They couldn't get me to sleep, and I felt the surgeon make the incision. They were giving me fentanyl and versed. When I reacted to the incision, they poured on more fentanyl. I stopped breathing. They "bagged" me, got me breathing again, and finished the surgery. The versed, which is supposed to make you forget everything, didn't work, and I remembered it all. Anesthesia is an uncertain thing, sometimes
firefly
 
  1  
Reply Wed 14 Nov, 2012 08:43 am
@PinkLipstick,
Quote:
Also, shouldn't a surgeon have done my surgery in a hospital and not a dentist in his private clinic with the lady who answers phone calls?

Dentists with the appropriate training and office equipment can administer various types of sedation and anesthesia ranging from the mild or minimal to the deep.
http://www.ada.org/sections/about/pdfs/anesthesia_guidelines.pdf

All kinds of surgery, and not just oral surgeries, can be done in outpatient settings. Most wisdom teeth extractions are done in an office setting. Most dentists probably do not have anesthesiologists in their office. Depending on the type of sedation or anesthesia used, the dentist would be responsible for administering and monitoring it, or supervising other staff and directing them in what to administer to the patient. Something that's administered orally could be given by someone other than the dentist, under his direction, but the dentist is responsible for monitoring the patient's response.

You really should discuss all of this with the oral surgeon you will see next week. If your dentist deviated from an appropriate standard of care, you can lodge a complaint, and/or request an investigation, by your county or state dental association and by your state licensing board.



0 Replies
 
ossobuco
 
  1  
Reply Wed 14 Nov, 2012 10:38 am
@mags314772,
Yikes. And I guess the versed didn't work on me either, since I'm telling the story (mine not a traumatic one, but yours and Pink's scary).

Pink lipstick, I don't know what is the norm for this kind of dental surgery - that would be interesting to find out.

PinkLipstick
 
  1  
Reply Wed 14 Nov, 2012 12:38 pm
@ossobuco,
I went to personally go see the dentist who did the operation and he gave me an ambiguous answer: "lets just wait and see and hopefully it comes back."

I asked for a more specific time range, like two more weeks? A month? A year? He wouldn't give me an answer. *Sigh*
ossobuco
 
  1  
Reply Wed 14 Nov, 2012 12:48 pm
@PinkLipstick,
I meant that I don't know the norm for who should do a total removal of wisdom teeth, and how it is preferably done, re pain relief.
firefly
 
  1  
Reply Wed 14 Nov, 2012 01:19 pm
@PinkLipstick,
Quote:
went to personally go see the dentist who did the operation and he gave me an ambiguous answer: "lets just wait and see and hopefully it comes back."

I asked for a more specific time range, like two more weeks? A month? A year? He wouldn't give me an answer.

No one can give you a precise, reliable time-frame for a nerve to recover from trauma because there is just too much individual variability involved. The dentist was simply being honest with you. You have to wait and see.

This sort of parasthesia is not an unheard of consequence after the extraction of wisdom teeth--it is a known risk, albeit not a great risk, of the extraction procedure itself. And it does not mean that the dentist necessarily did anything wrong to cause the problem.

The good news is that the problem is rarely ever permanent--the odds are you will regain sensation in the affected part of your face.

Be patient.

 

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