Complications of local anesthesia and endodontic treatment

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.

Sinusitis, maxillary sinus cyst, loss of sense of smell after visiting the dentist

The roots of the teeth of the upper jaw can normally be adjacent to the maxillary (maxillary) sinuses of the nose and even survive in them . Sinusitis, maxillary sinus cyst and loss of smell are possible when infection or filling material penetrates from the teeth into the paranasal sinuses. Unfortunately, this is not uncommon. Moreover, some cases of persistently recurrent sinusitis are associated with infection penetrating from the roots of the teeth . In this case, a possible symptom is a strong unpleasant odor from the nose and mouth.

Odontogenic sinusitis after treatment by a dentist

Odontogenic sinusitis (scheme). Teeth and maxillary sinus. On the left is the norm. On the right – the root of the “seven” (tooth 2_7) is destroyed, inflammation around the destroyed root, pus in the maxillary sinus.

Filling material in the maxillary sinus and sinusitis after filling the “six” canals (tooth 2_6). Pain in the left side of the face after visiting the dentist.

1 – roots of teeth, 2 – normal, air in the right maxillary sinus (front view, the air looks black in the picture), 3 – in the left maxillary sinus there is a fragment of filling material surrounded by an inflammatory shaft. The patient had been mistakenly receiving treatment for trigeminal neuralgia for a long time.

Cysts of the maxillary (maxillary) sinuses in diseases of the roots of the teeth.

1 – roots of the teeth, 2 – cysts of the maxillary sinuses, growing from the roots of the teeth (cysts are round “bubbles”, they look gray in the picture).

How can we help you:

1. Let's find the source of pain after dental treatment;
2. We will treat inflammatory processes, sinusitis, sinusitis and neurological complications; if necessary, your health will be taken care of jointly by a neurologist and an ENT doctor. Treatment of sinusitis without puncture

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.

Nerve damage during wisdom tooth extraction

29.10.2020

Probably, nature once wanted a person to be very wise and endowed him with a generous gift - eighth teeth, which now, unfortunately, cause considerable problems. The roots of “eights” are often curved; it is sometimes impossible to fully care for the dental units due to their inconvenient location, which entails the development of caries. In some cases, wisdom teeth bother their owner even at the initial stage of eruption. Considering that the eighth dental units do not bear a functional and aesthetic load, in certain situations a decision is made to remove them.

Possible pain after wisdom tooth removal

• Jaw pain. It can occur due to rupture of ligaments and blood vessels, as well as nerve endings, or the doctor applied light pressure on the jaw to gain access to a distant dental unit.
• Pain when swallowing. They appear after the “figure eight” on the lower jaw has been removed. This happens because a nerve was hit when a wisdom tooth was removed.

Basically, it is problematic to remove a dystopic or impacted tooth; it is located in the bone tissue and has not yet fully erupted. In this case, the bone is sawed and special forceps are used. There is a risk that damage to the trigeminal nerve will occur when wisdom teeth are removed. Persistent pain after removal of a tooth indicates pathology. If the body temperature rises, swelling and bruising appear, and you feel unwell, this indicates the presence of an inflammatory process.

Unbearable toothache usually occurs when the second and third “branches” of the trigeminal nerve become inflamed. Intense pain is localized in the ears, chin, even in the lower lip. Periodically, the acute pain dulls, but the person continues to experience discomfort. The reason is that a nerve was probably hit during the removal of a wisdom tooth, or unsuccessful dental procedures were performed: filling, surgical manipulations. In such a situation, you need to contact your dentist. The doctor will give appropriate recommendations on how to restore the nerve after tooth extraction. Typically, the patient is prescribed B vitamins, as well as drugs that stimulate blood circulation and reduce blood viscosity. Properly carried out therapy can achieve positive results and restore the nerve.

Causes of paresthesia

The “eight” has been successfully treated or removed, the patient returned from the dentist in perfect order, but suddenly a strange feeling of numbness appears on the cheeks, tongue, and lips. The effect of the anesthetic has passed, but the unpleasant symptoms continue: the face becomes as if plastic, tingling, burning, and sometimes pain are felt. These signs indicate the presence of paresthesia.

• Incorrect position of the figure eight, its curved roots or very close dislocation of the processes of the trigeminal nerve - these factors cause damage to the nerve during wisdom tooth removal.
• The wound is swollen and there is heavy bleeding, oxygen does not properly reach the nerve endings, and as a result, numbness occurs.
• When injecting into a diseased tooth, it is possible that the needle may enter the alveolar nerve. In this situation, the sensitivity of the tongue, chin and lips is not lost much; it only takes a few days to recover.

Symptoms of paresthesia can last a couple of days or several months, rarely more than a year. Numbness that does not go away over a long period of time is called chronic paresthesia. If this diagnosis is protracted, the patient is prescribed treatment:

• Drugs are prescribed to reduce blood viscosity and establish normal blood circulation, injections intramuscularly, intravenously.
• Physiotherapeutic procedures are carried out: UHF, mud treatment, electrophoresis, diadynamic currents, magnetic therapy.
• In the absence of positive results, they resort to surgical treatment, but such cases are rare.

If during therapy the patient continues to complain of a lack of sensitivity, he is additionally examined by a neurophysiologist and the type of neuropathy is determined based on electroneuromyography.

Professional surgeons – dentists, as a rule, are specialists in their field. They have excellent knowledge of anatomy, have an excellent understanding of the complex structure of the lower jaw canal, plus vast practical experience. Therefore, if wisdom tooth removal is prescribed according to indications, you should not delay it. Experienced, attentive dentists will definitely conduct a preliminary consultation with the patient before removal in order to dispel all his fears and doubts and prevent serious mistakes during treatment.

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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.

Pain after dental implantation, tooth implant hurts

During dental implantation, the trigeminal nerve and its branches, the alveolar nerve plexus, may be damaged as a result of:

1. Screwing the implant into the canal where the trigeminal nerve or its branches lies;
2. Inflammation in the implant area (infection and/or implant rejection).

Some pain during the implant healing process is normal. If the pain after dental implantation lasts too long, is very severe, or is accompanied by numbness of the lip or cheek, we can check the condition of the trigeminal nerve using electromyography and a neurological examination based on the characteristic loss of facial sensitivity and the spread of pain along the trigeminal nerve system.

The rejection reaction and inflammatory processes in the implant area are usually clearly visible with CORRECT X-ray examination and computed tomography.

Implants in the lower and upper jaw. Pain after dental implantation

There may be direct pressure from the implant on the nerve or inflammation in the implant area with tissue swelling, edema and subsequent pressure on the nerve.

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.

Treatment

Numbness after anesthesia goes away on its own if no damage or disturbance has occurred. In case of complications after surgery, the help of a specialist is necessary if:

1. numbness after treatment or removal does not go away after 24 hours;
2. when removing a wisdom tooth - after 1-5 days.

The nerve is completely restored after 2-3 weeks. Associated symptoms should be taken into account. Shooting pain in the tooth, burning sensation in the gums, sagging tissue indicate disturbances that occurred as a result of the operation. Nausea or vomiting is a sign of poisoning in the body. In difficult cases, treatment is required.

Complications after the use of anesthesia are quite common. If the damage is not too complex, and the doctor’s recommendations are fully followed, then surgery can be avoided.

Medicines

To restore damaged nerves and normalize blood circulation, dentists prescribe:

• vitamin complexes containing vitamins B and C;
• Actovegin, Piracetam and other medications.

Folk remedies

At home, rinsing with oak bark and chamomile decoction is used to relieve inflammation. Valerian root is used in an infusion, as it has a sedative effect and relaxes muscles. Furacilin solution has proven itself well; it is used for rinsing.

It is not recommended to use heating or cooling yourself. Despite the feeling of relief in the first minutes, such procedures can cause harm.

Physiotherapy

Dentists resort to prescribing ultrasound therapy to warm up the designated areas. This promotes tissue restoration.

What to do, how to treat

Treatment of paresthesia due to unsuccessful implantation can be prescribed by the implantologist who performed the operation, dentist, neurologist, or physiotherapist.

Before moving on to restorative therapy, a diagnosis must be carried out, during which the nature and extent of the damage is established. The treatment is carried out comprehensively, aimed at restoring the conductivity and sensitivity of nerve fibers .

If the patient consults a doctor immediately, drug therapy in combination with physiotherapeutic procedures is very effective. In other cases, surgery is required.

When do you need a doctor’s help and who to contact?

How long does numbness last after tooth extraction and when is it time to sound the alarm? It was already mentioned above that sensitivity should be restored a few hours after the anesthetic injection was given. But situations are different - for example, after a complex removal of the “eight”, after osteoplastic surgery or installation of an implant, etc. numbness can last 1-2 days, less often up to 5-7 or even up to 10-14 days. But, as practicing dentists note, sensitivity is restored after 2 weeks in almost all patients. If after 14 days there is no improvement, then you need to go to the doctor. To begin with, you can contact the dentist who performed the previous treatment, then you can contact a neurologist or a neurophysiologist.

Read on the topic: is it necessary to take an x-ray after a tooth has been removed?

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:

1. do not drink alcoholic beverages (at least 2 weeks before anesthesia);
2. monitor blood sugar and blood pressure levels;
3. 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