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I have had numbness/tingling around the lower

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jawline/lip/chin area for a while...
I have had numbness/tingling around the lower jawline/lip/chin area for a while. I thought it was a failed root canal...however, it turned out to be another tooth completely that had 2 cracks in it! They said the pressure and infection were causing the nerve sensations. I had the root canal about 2 1/2 weeks ago, but I am still experiencing some of the tingling in right side of chin and burning on lower corner of bot***** *****p. What is the likelihood that this will resolve itself completely?
Submitted: 8 years ago.Category: Dental
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Answered in 47 minutes by:
7/7/2009
Dentist: Julian Chen, Dentist replied 8 years ago
Julian Chen
Julian Chen, Dentist
Category: Dental
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Experience: Practicing General Dentist since 2002
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HiCustomer

Sorry to hear about your condition.

I do have a question for you. Since having the root canal done on #31, have you felt any improvements at all? (Reduction in numbness, tingling sensation.)

If the symptoms appear to be improving, then the prognosis for a full recovery will be very, very good. It will simply take a little more time for your body to completely clear itself of the infection and for the cells to regenerate and recuperate. You also want to follow-up closely to see if the infection has been cleared. If not, then you may benefit from another round of Amoxicillin.

However, if the symptoms have not improved at all, then I would be a little more weary and continue to follow-up with either the endodontist, or possibly go see an oral surgeon regarding other possible causes of numbness.

Best of luck to you.

Regards,

Jul***** *****, DDS
Julian Chen
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Customer reply replied 8 years ago
I am on a 2nd round of amoxicillin. There are some days that it feels fine and I don't notive it much and then others that I feel it more. I am no longer numb....just a little tingly around the lip/chin. My General Dentist said it could take a while to resolve itself since nerves heal slowly. He said he has never heard of a situation in which tingling does not resolve itself. Is this true?
Dentist: Julian Chen, Dentist replied 8 years ago
I would concur with your dentist in that I've yet to hear of a case where tingling does not fully resolve with time when symptoms have been progressively getting better. You can also try to help it along by occasionally using warm compresses. You can moisten up a hand towel and throw it into the microwave for a short interval to heat it up, and then carefully remove it and gently press along the right side of the face/jaw. Be sure that it is comfortably warm, and not too hot. This will help increase circulation and should promote slightly faster healing. But don't go expecting miraculous overnight results with this method. This is simply a way to improve and increase circulation, which would improve regeneration overall.

Regards,

Jul***** *****, DDS
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Customer reply replied 8 years ago
I also can feel the tingle more when I clench my jaw on that side. Is that normal? I know I probably shouldn't do that since it is healing.....

Thanks so much for your responses. I am much more relieved!
Customer reply replied 8 years ago
I also can feel the tingle more when I clench my jaw on that side. Is that normal? I know I probably shouldn't do that since it is healing.....

Thanks so much for your responses. I am much more relieved!
Customer reply replied 8 years ago

Also, I have had much anxiety over this and am wondering if this could prevent it from healing faster? I am just anxious, have no patience (although I need to) and I guess I was expecting it to completely be gone after the root canal.....

I know this is not realistic and I appreciate any and all feedback. My dentist and Endo said it could be a couple of weeks or even months before it fully heals itself.

Thanks for your input and time!

Dentist: Julian Chen, Dentist replied 8 years ago
anxiety could contribute to a slower healing rate. Anxiety (which is stress), has been shown to greatly affect the body's immune system. People under stress are sick more often and for longer periods of time as a result.

I would also agree with the general dentist and your endodontist in saying that full recovery may take upwards of a few months (possibly even up to 1 year). The key thing is it will progressively get better as it already has been and should eventually resolve itself. The only thing I would suggest is to make sure to have the area X-ray'd in another 5 months (which should make it about 6 months after the initial RCT) for your 6 month follow-up to make sure everything is okay.

Regards,

Jul***** *****, DDS
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Customer reply replied 8 years ago

Thank You very much Dr. Chen. You have been very helpful in alleviating some of my anxiety!

Customer reply replied 8 years ago

Dr. Chen,

I have full feeling back in the area, however, now I get a "burning" sensation that I never had before that is uncomfortable. Is this a good thing? It really comes and goes...I don't feel it all the time - sometimes I feel back to 99% normal. The tingling also went away for the most part (just a little now and then)....now it's just the burning in the corner of my mouth and 1/2 inch near my chin/jawline. I hope this means it's healing! It's been about 4 weeks since my root canal. Is this a good sign?

Dentist: Julian Chen, Dentist replied 8 years ago
This certainly sounds like a step in the right direction as the first thing you noted was that you have "full feeling back in the area." It is not uncommon for patients to note "burning" sensation as a symptom after injury to the nerves. And if you're doing this well at 4 weeks after the root canal, then this is very promising and I would expect full recovery to be sooner. It could still be anywhere from 2-3 months out, as you may occasionally still feel tingling or burning sensation at different regions. But again, it should progressive get better, so the frequency of symptoms should reduce.

But regardless of how well you might be feeling, be sure to get that 6 months post-op X-ray taken of the tooth/area to make sure everything is healing properly.

I'm pleased to hear that your condition is improving.

Best of luck to you,

Jul***** *****, DDS
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Customer reply replied 8 years ago
According to my x-rays the infection has cleared up and appears to be fine...now 12 weeks later, just the periodic tingling sensations. Plus, I now have to wear a night guard due to jaw clenching. I guess my real question is, when infection is near a nerve can it cause sensation for up to year or more (I heard from various dentists)? I am scheduled to have a crown placed on 10/21. If I'm still feeling slight tingling, etc., is it still ok to have it placed? Will it irritate the nerve more having the crown prep?
Dentist: Julian Chen, Dentist replied 8 years ago
How long it takes for the nerve to recover from the infection would depend on the location and amount of damage (assuming there was some damage) to the nerve. But as long as in the past few months, the area is feeling better, I see no reasons why it won't continue to get better and fully recover. It may take just a few more months. It could be another 6-12 months. Unfortunately, this isn't an exact science where we can say exactly on this particular date, you will recover.

In terms of the nerve being adversely affected by the crown preparation, this should not be the case. It is possible that anesthetic solution might not be even necessary for the crown procedure as the tooth has already been treated endodontically (RCT). A little bit of topical anesthetic might be used near the gum line if necessary, but that would be up to your restorative dentist. Even if anesthesia is used, it would be deposited towards the back of the jaw and nowhere near the site of the previous infection.

It is my opinion that the crown procedure will not irriate the nerve nor disrupt it's recovery.

Regards,

Jul***** *****, DDS
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Customer reply replied 8 years ago

Dr. Chen,

The location is the nerve bundle under tooth #31....extent of damage from infection is unknown. Thanks so much for your kind and informative responses. I do feel that it is getting better 12 weeks in...sometimes I think I don't feel the tingling/burning too much (or it doesn't bother me much - just slightly), then other days it's worse (and always when I'm more stressed - I have a history of anxiety issues, which I take periodic medication for and recently discovered that I have gastritis, due to stress, which is extremely painful). Needless to say, this doesn't help the healing process!!

I still have a temp filling in this tooth....what are the consequences if I get the temp crown placed in January? Is that too long? Reason being is that I have bite issues, clenching, etc., and thought I would wait for it to heal longer. I have it scheduled for October, but have some issues with getting it done since the nerve is still symptomatic.

Thanks again in advance for your professional input!

Dentist: Julian Chen, Dentist replied 8 years ago
Ideally, a successfully-treated root canal tooth should be restored with a final restoration (in the case of a molar, a crown) within 3 months after the root canal procedure. There is no hard scientific data established since it would not be an ethically feasible experiment. But the belief is the bacterial creep-rate will eventually penetrate the temporary filling/cement and leak into the root canal. If bacteria penetrates into the root canal, then the RCT will likely fail and result in another infection years down the road.

So if your most recent post-op X-ray shows that recovery is going well and the infection is gone, then my recommendation is to move forward with the final crown sooner rather than later. As the symptoms appear to be improving for you, at this time, there would be nothing (in my opinion) to suggest that moving forward with the final crown restoration could jeopardize your healing process.

Regards,

Jul***** *****, DDS
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Customer reply replied 8 years ago

Dr. Chen,

I had my root canal done approx 4 1/2 mos. ago and 1 week ago I've had the crown prep done and am now awaiting my final restoration next week. I still have some periodic tingling/burning sensation on the corner of my lip and sometimes feels like it's burning "in" the tooth, but appears to be less often (once/twice a week) - seems like the sensations move around somewhat. Post x-ray 2 months ago appears to be fine. I've now noticed that I have a slight sore throat after the crown prep (not everyday though). What could that be from? Could it be that the infection could have affected my wisdom tooth (horizontally impacted) or am I just a hypochondriac? I've never felt this until the crown prep.....

Dentist: Julian Chen, Dentist replied 8 years ago
I am unsure why you've developed a sore throat. It could be that you're coming down with a slight cold/flu. It could be from mouth-breathing at night. It could be over-exerting your vocal cords (business phone call, singing, yelling, talking on the phone extensively catching up with an old friend, etc...).

It is possible that #32 (your impacted wisdom tooth) is irritated by some excess temporary cement used to hold the temporary crown in place. But if this was the case, then you should feel some tenderness around the back side of #31 where the wisdom tooth is. If not, then I would say it is unrelated.

As I cannot perform a clinical exam nor review your X-rays, it may be best that you address these concerns to your treating dentist. He may or may not want you to come in for an evaluation. Either way, he's better suited than me at this time to address what is happening.

Regards,

Jul***** *****, DDS
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Customer reply replied 8 years ago

Dr. Chen,

My last question, I promise! After all of this pain and aggravation to tooth #31 (root canal, inflammation of the nerve bundle, etc.), the tooth was shaved down 5 months ago to prevent it from hitting the tooth above it to promote healing. In addition, tooth #30 had a crown that was also shaved down 3 months ago due to problems I was having with it. My dentist wanted both teeth to calm down, but as a result it shifted my bite on that side and my front pre-molars on that side were hitting hard due to not having the back two molars for support. I adjusted by not chewing on that side, making sure I didn't bring my teeth together during the day and wearing a nightguard.

Now I have had both crowns done and adjusted - they feel fine, but I still hit my front premolars first and have to work harder to bring my mouth together correctly on that side. Did something shift with my bite over the past 5 months? Is my jaw muscle just weaker or stiffer on that side due to not being in the correct position for so long? I figured once I had those 2 teeth for support everything would go back to normal. My dentist made a slight adjustment to the pre-molar, but it made no difference and he's hesitant to do more. Will my bite adjust back with time or do I go back to have the pre-molar adjusted? My jaw does pop sometimes, but after reading symptoms of tmj, mine is not that severe and I never had any problems until those back 2 teeth were shaved down so they could heal.

Thanks so much for your time!

Dentist: Julian Chen, Dentist replied 8 years ago
It sounds to me like the permanent crowns on #30 & #31 are a bit shorter than ideal. This doesn't mean that they're bad nor do they need to be replaced (unless they are excessively short). However, obviously this affects your overall bite and we'll have to see how your teeth responds.

In general, teeth have a natural tendency to drift/tilt foward and continuously erupt (until they hit something). So in theory, given enough time, the #30 & #31 should both re-establish the proper contacts and even out your bite. But if anything, it's always better to have the crowns slightly shorter than being too tall.

It is unlikely that your jaw shifted significantly in the past 5 months. If it did, it would usually result in the crowns being too high, not too short/low. But this last statement is based more upon when the actual impressions were taken and when the crowns were fabricated. It is more likely that the lab may have inadvertently made them shorter.

Regards,

Jul***** *****, DDS
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