Two weeks ago i had an implant put in my mouth on the right side of my lower jaw. Unfortunately my dentist drilled to far with the implant drill and nicked the Inferior alveolar nerve which provide sensation to my lower lip, chin as well as gums and teeth. It took me a week just to come to terms with. I'm trying to remain hopeful but its hard.
this. My dentist informed me that nerves heal slow and this might take weeks months or even a year. He cant even guarantee ill ever get feeling back. The tightness in my lower right teeth are the hardest thing to deal with right now. Its feels like a have toothpicks stuck between each of them.
My current dilemma is trying to decide whether or not to remove the existing implant that he was then able to install. We confirmed the next day by 3d scan that the implant he installed is not near the nerve canal so his feeling was to leave it in. I would rather leave it in and not risk causing more damage to an already injured nerve. Now the confusing part is when i got a second opinion from a different dentist he advised me to take the implant out. My question is if its not violating the nerve canal what is the harm in leaving it in? He acknowledge that there is no physical impingement to the nerve from the implant but wont elaborate further about why to remove it. I just want to make sure i give myself every opportunity to heal. I just dont know whether to leave it in or take it out. Any suggestion or any other healing tips or protocol in this type of situation would be greatly appreciated. Thanks Mike

Hi Mike,

I'm sorry to hear this has happened to you. As you have been told, the longevity or permanency of the nerve damage is unpredictable in both cases ... keeping the implant or removing it.

The conflict with to remove the implant or not has several concerning issues. You will get pros and cons from every dentist you see.

One of the concerns with leaving it in has to do with the bio-film that always builds up around the circumference of the dental implant. This is a natural immune stimulated response that occurs around any foreign part put into the body. The bio-film is not necessarily infectious at the onset, but it could become infectious. The concern is that if it were to become infectious that the infection would have any easy pass into the nerve and beyond.

One of the concerns with removing the implant is that it would cause further trauma to the jaw bone and further trauma to the already inflamed nerves that have been affected by the initial nerve trauma. So it you were to have it removed it would behoove you to do that asap before new bone starts to grow and migrate against the implant making removal more traumatic later on.

Another concern that your dentists may or may not be thinking of or discussing with you is the history of the tooth that was extracted. If that tooth was a root canaled or had been infected, then you there is a possibility that unfavorable changes have already occurred in that area of your bone prior to the extraction. This history of infection could increase the possibility of the bio film becoming infected as it is can be very difficult to remove all of the infected tissue caused by a root canaled or an infected tooth when the tooth is extracted.

Another issue is with regard to the adjacent teeth of where the implant was placed. Are either of those teeth root canaled? If so, then the bacteria leaching from those teeth is traveling into the same blood vessels that surround the nerve bed and the dental implant making that area not an ideal place for an implant to begin with. Add to that the traumatized nerve and inflammation and you can see how it would be like adding insult to injury to have an implant in that area. If the adjacent teeth are not root canaled but are healthy, then the concern about those teeth affecting the implant is much less or likely as long as they stay healthy.

Did the oral surgeon tell you of the nerve trauma and immediately offer you the option of not putting in the dental implant? Or did he put the implant in and then tell you of the nerve trauma?

Was the second opinion gotten from another oral surgeon or a general dentist? It should have been an oral surgeon. I would contact him and ask him to elaborate on his reasons for suggesting to remove the implant. He cannot expect you to just take his word without explanation. If he is seems reluctant to give you straight forward answers so you understand his reasoning, then I would consult with a 3rd oral surgeon and specifically want to be given his reasons for his decision.

Pertaining to nerve health, ideally eat a nutritious whole foods diet and supplement with vitamins that specifically target nerve health. You can do a google search on those vitamins. You will see information about B complex, vitamin C and D3, Alpha Lipoic Acid, etc. I am not endorsing any specific name brand products but an educational read on this top is at Neuropathy, the pain of nerve damage and what can be done
about it.

Bryanna

Mike...please read this a few times.
I experienced bad nerve damage after what I feel was incompetent behavior by my dentist. After 3.5 years, a root canal, the removal of the tooth, many medications etc. it is finally somewhat better. The pain is still present and with me almost always, but I have more control than in the past. Originally, it was unbearable. I often had to take narcotics and still have them at my disposal. I am happy that I have more control, but am surprised it took so long to get to a decent place. Saddened that I think it will likely be with me forever, but pleased that at least I have more control. I use many meds, one that is specially made for me. I also eat in a very healthy manner to try to keep my body in optimal shape ....hopefully the body can do some healing on its own.

Don't hesitate to seek the opinion of a other dental professionals for their opinion only. I was very lucky in that I found an oral surgeon who was also an MD who gave me valuable insight and led me to a NEUROLOGIST. Which brings me to my second point, don't hesitate to see a neurologist if you are not improving over a decent period of time.

Also, if you think your dentist was lax/ incompetent in any way, consider seeing an attorney to discuss possible legal options. I think sometimes these things are just simply bad outcomes and other times there is more to it involving incompetence. Time will be important in any potential lawsuit.

I hope this is NOT the case and I hope you feel better soon. I heard sometimes nerves heal on their own....often it is slow, etc. After 3.5 years I'm not particularly confident anymore for myself, but, like I said, I am happy that at least I can often control the pain with medications.

Also, very very generally... I never found my adjacent teeth to be an issue in my case. I did not find removing my tooth helpful, but I did not have an implant...only a graph put in and then removed. I think in retrospect, I wish I had taken things a little slower. I found most of my dentists very uninformed re nerve damage and pain. It is a difficult predicament. I'm so sorry. I hope you feel better soon and are one of the lucky ones that heal relatively quickly. It absolutely does happen. Also... take in/seriously consider, professional opinions, but trust your instincts.