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Mark Bornfeld, DDS
Mark Bornfeld, DDS, Dentist
Category: Dental
Satisfied Customers: 5728
Experience:  Clinical instructor, NYU College of Dentistry; 37 years private practice experience in general dentistry, member Academy of General Dentistry, ADA
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Facial Numbness.Only around my left upper lip.Extends to

Resolved Question:

<p>Facial Numbness. Only around my left upper lip. Extends to the left side of my nose and nostral. Two or three days of numbness and tigling. Just woke up with it very numb. No inflation. Just starting to really hurt.<br/>Doctor yesterday cleared me of any brain probs from movement tests.<br/>Mentioned I had sever pain in my left cheek bone nite prior.<br/>Dr was convinced it was dental issue.</p><p>Dentist couldn't find anyting in upper left from xrays.<br/>However did find xrays from 12 months ago with tooth absyss in bottom left back tooth.<br/>Which has NOT been treated since. Dr was convinced absyss would be much worse now.Felt it was referred pain.<br/>Has made appointment with endodontist for root cacal work based on xray from 12 months ago.<br/>After researching tooth absys today I understand leaving it untreated could be very dangerous.<br/>I'm still recovering from last root canal mental scaring and financial scaring as well.<br/>Want to be sure this is the correct way to proceed.<br/>Don't want to spend a forture and still have face numbness after.</p><p> </p><p> </p>
Submitted: 3 years ago.
Category: Dental
Expert:  replied 3 years ago.
Welcome to JustAnswer, and thank you for putting your trust in me!

There are several issues that could conceivably cause pain and numbness in the area of the upper lip and side of the nose. However, regardless of the need for root canal therapy (which I cannot dispute due to my inability to examine the diagnostic record), an infection in a lower tooth would not cause numbness in the area you describe. Therefore, if your main intent is to treat the numbness and pain in the upper lip and side of the nose, you will need to dig deeper first in order to identify the cause.

The area you describe is supplied by a specific sensory nerve-- the maxillary branch of the trigeminal, or 5th cranial nerve. Pain and numbness could result from anything that affects this nerve along its course, from the base of the brain (the trigeminal ganglion), to the entire length of the nerve, which passes above the upper teeth in the roof of the sinus. In other words, a compression of the ganglion in the cranial base from an intracranial artery might do it, as could an infection in one of the upper teeth, or an acute sinus infection. An inflammation of the nerve could likewise cause this symptom, as might occur from a viral infection such as herpes zoster (shingles), or a neuropathy secondary to a disease state, such as diabetes or multiple sclerosis.

Because your dentist has ruled out a dental infection in the upper teeth, it is unlikely that your current symptoms are due to dental disease. (That is not to say that your dentist couldn't be wrong, but logic dictates that the search first be directed elsewhere.)

Based on your description, your complaint is most likely due to either a sinus infection or a neurological issue. For that reason, it makes sense to be re-examined by a medical doctor to further explore these possibilities, with a referral to either an otolaryngologist or a neurologist as deemed appropriate. Of course, you should proceed with your lower tooth root canal when feasible, but if your current symptoms are a priority, your medical consultation should come first.

Hope this helps...
Mark Bornfeld, DDS, Dentist
Category: Dental
Satisfied Customers: 5728
Experience: Clinical instructor, NYU College of Dentistry; 37 years private practice experience in general dentistry, member Academy of General Dentistry, ADA
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